Department of Gastroenterology and Hepatology, University Medical Center Utrecht, The Netherlands.
J Crohns Colitis. 2012 May;6(4):435-40. doi: 10.1016/j.crohns.2011.09.014. Epub 2011 Nov 9.
The increased risk of colorectal cancer (CRC) in patients with inflammatory bowel disease (IBD) is well established. The incidence of IBD-related CRC however, differs markedly between cohorts from referral centers and population-based studies. In the present study we aimed to identify characteristics potentially explaining these differences in two cohorts of patients with IBD-related CRC.
PALGA, a nationwide pathology network and registry in The Netherlands, was used to search for patients with IBD-associated CRC between 1990 and 2006. Patients from 7 referral hospitals and 78 general hospitals were included. Demographic and disease specific parameters were collected retrospectively using patient charts.
A total of 281 patients with IBD-associated CRC were identified. Patients from referral hospitals had a lower median age at IBD diagnosis (26 years vs. 28 years (p=0.02)), while having more IBD-relapses before CRC diagnosis than patients from general hospitals (3.8 vs. 1.5 (p<0.01)). In patients from referral hospitals, CRC was diagnosed at a younger age (47 years vs. 51 years (p=0.01)). However, the median interval between IBD diagnosis and diagnosis of CRC was similar in both cohorts (19 years in referral hospitals vs. 17 years in general hospitals (p=0.13)).
IBD patients diagnosed with CRC treated in referral hospitals in The Netherlands are younger at both the diagnosis of IBD and CRC than IBD patients with CRC treated in general hospitals. Although patients from referral centers appeared to have a more severe course of IBD, the interval between IBD and CRC diagnosis was similar.
炎症性肠病（IBD）患者结直肠癌（CRC）的风险增加已得到充分证实。然而，IBD 相关 CRC 的发病率在转诊中心和基于人群的研究队列之间存在显著差异。本研究旨在确定两个 IBD 相关 CRC 患者队列中可能解释这些差异的特征。
荷兰全国性病理学网络和注册处 PALGA 用于 1990 年至 2006 年间搜索 IBD 相关 CRC 患者。纳入了来自 7 家转诊医院和 78 家综合医院的患者。使用患者病历回顾性收集人口统计学和疾病特异性参数。
共确定了 281 例 IBD 相关 CRC 患者。转诊医院的患者在 IBD 诊断时的中位年龄较低（26 岁比 28 岁（p=0.02）），在 CRC 诊断前的 IBD 复发次数多于综合医院的患者（3.8 次比 1.5 次（p<0.01））。在转诊医院的患者中，CRC 的诊断年龄较小（47 岁比 51 岁（p=0.01））。然而，两个队列中 IBD 诊断和 CRC 诊断之间的中位间隔相似（转诊医院 19 年，综合医院 17 年（p=0.13））。
荷兰转诊医院治疗的 IBD 患者在诊断 IBD 和 CRC 时均比在综合医院治疗的 IBD 患者 CRC 患者年龄更小。尽管来自转诊中心的患者似乎具有更严重的 IBD 病程，但 IBD 和 CRC 诊断之间的间隔相似。
