Saber Toufic, Bedran Khalil, Ghandour Fatima, El Khoury Mansour, Bou Khalil Roula, Farhat Said
Saint Georges Hospital Medical Center Beirut Lebanon, Beirut, Lebanon.
Departmentof Gastroenterology, Saint Georges Hospital Medical Center Beirut Lebanon, Beirut, Lebanon.
BMJ Open Gastroenterol. 2017 Sep 25;4(1):e000167. doi: 10.1136/bmjgast-2017-000167. eCollection 2017.
Inflammatory bowel diseases (IBDs) and colorectal cancer have an increased impact on the Lebanese population's morbidity and mortality. This study evaluated the situation of IBD and colorectal cancer at a tertiary hospital centre in Lebanon.
1007 patients underwent colonoscopy over a period of 12 months by qualified physicians. 91 patients were excluded from the study. Biopsy results were divided into normal versus abnormal colonic tissue. The abnormal section was further subdivided into number of polyps, IBD, dysplasia and cancer.
Out of 916 individuals included, 61 cases of Crohn's colitis (CC) (6.7%) and 24 cases of ulcerative colitis (UC) (2.7%) were identified. A total of 92 cases of colorectal cancer (10.04%) were also identified. There was a slight male predominance in both groups of IBD without any statistical significance. One statistical significance was reported in favour to age<50 years in both IBD groups with a mean age of 37.9±9.7 years and 34.4±6.4 years for CC and UC, respectively. The incidence of granuloma in the CC group was 8.9% without any correlation compared with age or gender. No correlation was made between colorectal cancer and the existence of any IBD type. The data showed that age >50 years and male gender significantly correlate with an increased incidence of precancerous and cancerous polyps in the colon. They significantly correlate with adenocarcinoma. The estimated incidence of colorectal cancer, CC and UC was 54.1, 35.8 and 14.1 per 100 000, respectively, with a denominator of 169 959 patients per year.
Within the limitations of this study, the incidence of colorectal cancer and IBD falls in the high range compared with similar European and American studies. Our data are biased because of the tertiary centre setting but they can be considered as base for further investigations.
炎症性肠病(IBD)和结直肠癌对黎巴嫩人口的发病率和死亡率影响日益增加。本研究评估了黎巴嫩一家三级医院中心的IBD和结直肠癌情况。
在12个月期间,1007例患者接受了由合格医生进行的结肠镜检查。91例患者被排除在研究之外。活检结果分为正常与异常结肠组织。异常部分进一步细分为息肉数量、IBD、发育异常和癌症。
在纳入的916例个体中,确诊61例克罗恩结肠炎(CC)(6.7%)和24例溃疡性结肠炎(UC)(2.7%)。还共确诊92例结直肠癌(10.04%)。两组IBD中男性略占优势,但无统计学意义。在两个IBD组中,均报告了年龄<50岁具有统计学意义,CC组和UC组的平均年龄分别为37.9±9.7岁和34.4±6.4岁。CC组中肉芽肿的发生率为8.9%,与年龄或性别无任何相关性。结直肠癌与任何IBD类型的存在之间均无相关性。数据显示,年龄>50岁和男性性别与结肠中癌前和癌性息肉的发病率增加显著相关。它们与腺癌显著相关。结直肠癌、CC和UC的估计发病率分别为每10万人54.1、35.8和14.1例,每年的分母为169959例患者。
在本研究的局限性范围内,与类似的欧美研究相比,结直肠癌和IBD的发病率处于较高水平。由于本研究为三级中心设置,我们的数据存在偏差,但可作为进一步研究的基础。