Marsch S C, Heer M, Sulser H, Hany A
Medizinische Klinik, Kantonsspital Winterthur.
Schweiz Med Wochenschr. 1990 Feb 3;120(5):135-41.
We describe three patients with celiac disease complicated by adenocarcinoma of the small intestine, and summarize the 36 cases of this association that have been reported. Retrospectively we found an increased risk (relative risk 25-250) of developing adenocarcinoma of the small intestine in patients with celiac disease in the region of Winterthur (north-east Switzerland). We therefore suggest that celiac disease be considered a premalignant condition not only for malignant lymphoma and gastrointestinal tumors, but also for adenocarcinoma of the small intestine. Synchronous or metachronous development of carcinoma in one of our patients and in two cases reported in the literature offer further evidence that celiac disease is a premalignant condition for adenocarcinoma of the small bowel. In several patients celiac disease was diagnosed only after diagnosis of the carcinoma. With regard to asymptomatic or subclinical celiac disease, it seems justifiable to search for possible underlying celiac disease in all patients with established diagnosis of adenocarcinoma of the small intestine.
我们描述了3例患有腹腔疾病并并发小肠腺癌的患者，并总结了已报道的36例这种关联病例。回顾性研究发现，在温特图尔地区（瑞士东北部），腹腔疾病患者发生小肠腺癌的风险增加（相对风险为25 - 250）。因此，我们建议腹腔疾病不仅应被视为恶性淋巴瘤和胃肠道肿瘤的癌前病变，也应被视为小肠腺癌的癌前病变。我们的1例患者以及文献报道的2例患者中癌的同步或异时发生，进一步证明腹腔疾病是小肠腺癌的癌前病变。在一些患者中，腹腔疾病仅在癌症诊断后才被确诊。对于无症状或亚临床腹腔疾病，在所有已确诊小肠腺癌的患者中寻找可能潜在的腹腔疾病似乎是合理的。
