日本人群中溃疡性结肠炎相关肿瘤的 36 年监测计划结果。

Results of a 36-year surveillance program for ulcerative colitis-associated neoplasia in the Japanese population.

机构信息

Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan.

Department of Pathology, The University of Tokyo, Tokyo, Japan.

出版信息

Dig Endosc. 2018 Mar;30(2):236-244. doi: 10.1111/den.12955. Epub 2017 Nov 2.

DOI:10.1111/den.12955

PMID:28836702

Abstract

BACKGROUND AND AIM

Surveillance colonoscopy has been carried out for patients with long-standing ulcerative colitis who have an increased risk for colorectal cancer. The aim of the present study was to determine the incidence of and the risk factors for neoplasia.

METHODS

We evaluated 289 ulcerative colitis patients who underwent surveillance colonoscopy between January1979 and December 2014. Cumulative incidence of neoplasia and its risk factors were investigated. Clinical stage and overall survival were compared between the surveillance and non-surveillance groups.

RESULTS

Cumulative risk of dysplasia was 3.3%, 12.1%, 21.8%, and 29.1% at 10, 20, 30 and 40 years after the onset of ulcerative colitis, respectively. Cumulative risk of colorectal cancer was 0.7%, 3.2%, 5.2%, and 5.2% at 10, 20, 30 and 40 years from the onset of ulcerative colitis, respectively. Total colitis was a risk factor for neoplasia (P = 0.015; hazard ratio, 2.96).

CONCLUSIONS

Our surveillance colonoscopy program revealed the incidence and risk factors of ulcerative colitis-associated neoplasias in the Japanese population. Total colitis is a risk factor for neoplasia.

摘要

背景与目的

对患有结直肠癌风险增加的长期溃疡性结肠炎患者进行监测结肠镜检查。本研究旨在确定肿瘤的发生率和危险因素。

方法

我们评估了 1979 年 1 月至 2014 年 12 月期间接受监测结肠镜检查的 289 例溃疡性结肠炎患者。研究了肿瘤的累积发生率及其危险因素。比较了监测组和非监测组的临床分期和总生存率。

结果

溃疡性结肠炎发病后 10、20、30 和 40 年，异型增生的累积风险分别为 3.3%、12.1%、21.8%和 29.1%。溃疡性结肠炎发病后 10、20、30 和 40 年，结直肠癌的累积风险分别为 0.7%、3.2%、5.2%和 5.2%。全结肠炎是肿瘤的危险因素（P = 0.015；风险比，2.96）。