Zhiqin Wong, Palaniappan Shanthi, Raja Ali Raja Affendi
Department of Gastroenterology and Hepatology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Department of Gastroenterology and Hepatology, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia. ; Medical Molecular Biology Institute, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Intest Res. 2014 Jul;12(3):194-204. doi: 10.5217/ir.2014.12.3.194. Epub 2014 Jul 25.
Patients with inflammatory bowel disease (IBD) are at an increased risk of developing colorectal cancer (CRC), and key contributing factors include chronic colonic inflammation and the extent and duration of disease. This increase in risk is more likely to result from chronic inflammation of the colonic mucosa than from any clearly defined genetic predisposition. However, globally, the true magnitude of this risk is debatable, since results from different studies are heterogeneous in terms of geographical and methodological variables. The prevalence of IBD-related CRC in the Asia-Pacific region ranges from 0.3% to 1.8% and a recent study found that the cumulative incidence of IBD-related CRC is comparable to that in Western countries. However, the CRC mortality rate in the Asia-Pacific region is on the rise compared with that in Western countries, and a few Asian countries show particularly rapid upward trends in CRC incidence. Although our understanding of the molecular and clinical basis for IBD-related CRC has improved substantially, our means of prevention, endoscopic surveillance, chemoprevention, and prophylactic surgery remain modest at best. Furthermore, published data on IBD-related CRC in the Asia-Pacific region is lacking, and this review addresses many aspects including epidemiology, natural history, etiopathogenesis, morphology, and biological behaviors of IBD-related CRC and sporadic CRC in the Asia-Pacific region. In this review, we will also discuss the risk factors for CRC in IBD patients, endoscopic technology screening, and surveillance programs and management strategies for IBD-related CRC.
炎症性肠病（IBD）患者患结直肠癌（CRC）的风险增加，主要促成因素包括慢性结肠炎症以及疾病的范围和持续时间。这种风险增加更可能是由结肠黏膜的慢性炎症引起的，而非任何明确的遗传易感性。然而，在全球范围内，这种风险的真实程度存在争议，因为不同研究的结果在地理和方法变量方面存在异质性。亚太地区IBD相关CRC的患病率在0.3%至1.8%之间，最近一项研究发现，IBD相关CRC的累积发病率与西方国家相当。然而，与西方国家相比，亚太地区的CRC死亡率正在上升，一些亚洲国家的CRC发病率呈现出特别快速的上升趋势。尽管我们对IBD相关CRC的分子和临床基础的理解有了很大提高，但我们的预防、内镜监测、化学预防和预防性手术手段充其量仍很有限。此外，亚太地区缺乏关于IBD相关CRC的已发表数据，本综述探讨了许多方面，包括亚太地区IBD相关CRC和散发性CRC的流行病学、自然史、病因发病机制、形态学和生物学行为。在本综述中，我们还将讨论IBD患者患CRC的风险因素、内镜技术筛查以及IBD相关CRC的监测计划和管理策略。
