Ishimaru Kazuhide, Tominaga Tetsuro, Nonaka Takashi, Fukuda Akiko, Moriyama Masaaki, Oyama Shosaburo, Ishii Mitsutoshi, Sawai Terumitu, Nagayasu Takeshi
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Surg Case Rep. 2021 Jun 28;7(1):152. doi: 10.1186/s40792-021-01237-0.
Colorectal cancer (CRC) is the most malignant complication in patients with Crohn's disease (CD). We report 6 cases of CD-related CRC treated surgically at our hospital.
From 2010 to 2016, six CD patients were diagnosed with CRC. All patients were diagnosed with CD at < 25 years old, and the interval from onset of CD to diagnosis of CRC was > 10 years (range, 15-42 years) in all patients. The histological type of cancer was mucinous carcinoma in two cases, well-differentiated tubular adenocarcinoma in two cases, and moderately differentiated tubular adenocarcinoma in two cases. CRC was detected by screening colonoscopy in three cases (50%), and from clinical symptoms in the remaining three cases (50%). Two cases underwent colonoscopy within 2 months after symptom onset, detecting CRC in the relatively early stage. However, one case was diagnosed with advanced-stage CRC by endoscopy 1 year after symptom onset, and experienced poor prognosis.
Regular surveillance colonoscopy is needed to detect early-stage CRC in CD patients. Clear surveillance methods need to be established based on evidence.
结直肠癌（CRC）是克罗恩病（CD）患者最严重的并发症。我们报告我院手术治疗的6例CD相关CRC病例。
2010年至2016年，6例CD患者被诊断为CRC。所有患者在25岁之前被诊断为CD，所有患者从CD发病到CRC诊断的间隔时间>10年（范围15 - 42年）。癌症的组织学类型为黏液癌2例，高分化管状腺癌2例，中分化管状腺癌2例。3例（50%）通过筛查结肠镜检查发现CRC，其余3例（50%）通过临床症状发现。2例在症状出现后2个月内接受结肠镜检查，在相对早期发现CRC。然而，1例在症状出现1年后通过内镜诊断为晚期CRC，预后较差。
需要定期进行监测结肠镜检查以在CD患者中检测早期CRC。需要根据证据建立明确的监测方法。
