Desai Devendra, Shah Sudeep, Deshmukh Abhijit, Abraham Philip, Joshi Anand, Gupta Tarun, Deshpande Ramesh, Khandagale Varun, George Siji
Devendra Desai, Abhijit Deshmukh, Philip Abraham, Anand Joshi, Tarun Gupta, Varun Khandagale, Siji George, Division of Gastroenterology, P.D Hinduja Hospital, Mumbai 400016, India.
World J Gastroenterol. 2015 Mar 28;21(12):3644-9. doi: 10.3748/wjg.v21.i12.3644.
To determine the incidence and risk factors for colorectal cancer (CRC) in patients with ulcerative colitis from a low prevalence region for CRC.
Our prospective database yielded a cohort of 430 patients [age: 44 ± 14.6 years; 248 men (57.7%)] with ulcerative colitis (median disease duration 6, range: 1-39 years) for analysis. Of these, 131 (30.5%) had left-sided colitis and 159 (37%) extensive colitis. Patients with histologically confirmed CRC within the segment with colitis were compared with those without CRC, to determine the risk factors for the development of CRC.
Twelve patients (2.8%) developed CRC. The overall incidence density was 3.56/1000 patient-years of disease - 3/1000 in the first 10 years, 3.3/1000 at 10 to 20 years, and 7/1000 at > 20 years. Three of our 12 patients developed CRC within 8 years of disease onset. On univariate analysis, extensive colitis, longer duration of disease, and poor control of disease were associated with development of CRC. On multivariate analysis, duration of disease and extent of colitis remained significant.
CRC occurred in 2.8% of patients with ulcerative colitis in our population - an incidence density similar to that in Western countries in spite of a low overall prevalence of colon cancer in our population. The risk increased with extent and duration of disease.
确定来自结直肠癌低发地区的溃疡性结肠炎患者结直肠癌（CRC）的发病率及危险因素。
我们的前瞻性数据库纳入了430例溃疡性结肠炎患者[年龄：44±14.6岁；男性248例（57.7%）]进行分析，其溃疡性结肠炎中位病程为6年（范围：1 - 39年）。其中，131例（30.5%）为左侧结肠炎，159例（37%）为广泛性结肠炎。将结肠炎节段内组织学确诊为CRC的患者与未患CRC的患者进行比较，以确定CRC发生的危险因素。
12例患者（2.8%）发生CRC。总体发病密度为3.56/1000患者 - 年病程——发病首10年为3/1000，10至20年为3.3/1000，超过20年为7/1000。12例患者中有3例在发病8年内发生CRC。单因素分析显示，广泛性结肠炎、病程较长及病情控制不佳与CRC发生相关。多因素分析显示，病程及结肠炎范围仍具有显著意义。
在我们的研究人群中，2.8%的溃疡性结肠炎患者发生了CRC——尽管我们人群中结肠癌总体患病率较低，但其发病密度与西方国家相似。发病风险随病情范围及病程增加而升高。
