Mount Sinai Hospital IBD Centre, University of Toronto, Toronto, Ontario, Canada.
Gastrointest Endosc. 2013 Mar;77(3):351-9. doi: 10.1016/j.gie.2012.11.030. Epub 2013 Jan 12.
The paradigm for neoplasia surveillance in IBD is rapidly evolving with advancements in endoscopic imaging technology. Modern technology has demonstrated a remarkably improved capacity to detect and characterize subtle neoplastic lesions. As such, practices of obtaining interval random biopsy specimens to identify “invisible”neoplasia and of recommending total proctocolectomy for treatment of early neoplastic lesions are gradually being phased out. Further research is required to confirm the safety and effectiveness of endoscopic resection of more advanced neoplastic lesions, including DALMs and lesions bearing HG-IEN. Moving forward, studies evaluating CRC risk profiles in IBD patients would be useful to develop rational and cost-effective individualized strategies for neoplasia surveillance and management. Overall, as we progress toward more sophisticated approaches to cancer prevention, the outlook for IBD patients grows ever better.
随着内镜成像技术的进步，肿瘤监测在炎症性肠病中的模式正在迅速发展。现代技术已经证明，在检测和描述细微的肿瘤病变方面具有显著提高的能力。因此，为了发现“看不见”的肿瘤而获取间隔随机活检标本的做法，以及推荐进行全结肠直肠切除术以治疗早期肿瘤病变的做法正在逐渐被淘汰。需要进一步的研究来证实内镜切除更高级别的肿瘤病变的安全性和有效性，包括 DALMs 和具有 HG-IEN 的病变。展望未来，评估炎症性肠病患者 CRC 风险特征的研究将有助于制定合理且具有成本效益的肿瘤监测和管理个体化策略。总的来说，随着我们朝着更复杂的癌症预防方法发展，炎症性肠病患者的前景越来越好。
