Hisamatsu Tadakazu
Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University.
Nihon Rinsho. 2014 Jan;72(1):56-62.
Inflammatory bowel disease (IBD), ulcerative colitis (UC) and Crohn's disease (CD), have been considered as a risk of colorectal cancer (CRC). CRC associated with chronic intestinal inflammation has been known as "colitic cancer". Molecular mechanisms for developing of colitic cancer are different from those of sporadic CRC known as adenomacarcinoma sequence. Colitic cancer often involves dysplasia as precancerous lesions. Mutation of p53 gene is often observed not only in colitic cancer but also in dysplasia. Theory of "field cancerization" applies in colitic cancer resulting in several difficulties in clinical management of it such as multifocality and heterochrony.
炎症性肠病（IBD），包括溃疡性结肠炎（UC）和克罗恩病（CD），一直被视为结直肠癌（CRC）的一种风险因素。与慢性肠道炎症相关的结直肠癌被称为“结肠炎性癌”。结肠炎性癌的发生分子机制与以腺瘤-癌序列为特征的散发性结直肠癌不同。结肠炎性癌常伴有发育异常作为癌前病变。p53基因的突变不仅在结肠炎性癌中常见，在发育异常中也经常被观察到。“场癌化”理论适用于结肠炎性癌，这给其临床管理带来了诸多困难，如多灶性和异时性。
