Hernández Vicent, Clofent Juan
Digestive Diseases Department, Complexo Hospitalario Universitario de Vigo (Vicent Hernández).
Digestive Diseases Section, Internal Medicine Department. Hospital de Sagunto (Juan Clofent), Spain.
Ann Gastroenterol. 2012;25(3):193-200.
Inflammatory bowel diseases (IBD) are associated to an increased risk of colorectal cancer, which is primarily related to long-standing chronic inflammation. Recognized risk factors are the duration and extent of the disease, severe endoscopic and histological inflammation, primary sclerosing cholangitis, family history of colorectal cancer and in some studies young age at diagnosis. Recent population-based studies have shown that the risk is lower than previously described or even similar to that of the general population, and this could be justified by methodological aspects (hospital-based vs. population-based studies) or by a true decrease in the risk related to a better control of the disease, the use of drugs with chemoprotective effect or the spread of endoscopic surveillance in high-risk patients. Apart from colorectal cancer, patients with IBD are prone to other intestinal neoplasms (lymphoma, small bowel adenocarcinoma, pouch neoplasia and perianal neoplasia). In this article, the magnitude of the risk of intestinal cancer, the risk factors, the natural history of dysplasia and the recommendations of screening and surveillance in IBD are reviewed.
炎症性肠病（IBD）与结直肠癌风险增加相关，这主要与长期慢性炎症有关。公认的风险因素包括疾病的持续时间和范围、严重的内镜和组织学炎症、原发性硬化性胆管炎、结直肠癌家族史，以及在一些研究中诊断时的年轻年龄。最近基于人群的研究表明，该风险低于先前描述的风险，甚至与普通人群相似，这可能是由于方法学方面的原因（基于医院的研究与基于人群的研究），或者是由于与疾病更好控制、使用具有化学保护作用的药物或在高危患者中开展内镜监测的普及相关的真正风险降低。除了结直肠癌外，IBD患者还易患其他肠道肿瘤（淋巴瘤、小肠腺癌、储袋肿瘤和肛周肿瘤）。本文综述了IBD患者患肠道癌症的风险程度、风险因素、发育异常的自然史以及筛查和监测建议。
