Wang Man, Yu Ming, Kong Wen-Jie, Cui Mei, Gao Feng
Department of Gastroenterology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China.
Department of General Practice, Xiangyang Central Hospital, The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang 441021 Hubei Province, China.
World J Gastrointest Oncol. 2021 Sep 15;13(9):1017-1028. doi: 10.4251/wjgo.v13.i9.1017.
Celiac disease (CD) is a chronic immune-mediated intestinal disease with genetic susceptibility. It is characterized by inflammatory damage to the small intestine after ingestion of cereals and products containing gluten protein. In recent years, the global prevalence rate of CD has been approximately 1%, and is gradually increasing. CD patients adhere to a gluten-free diet (GFD) throughout their entire life. However, it is difficult to adhere strictly to a GFD. Untreated CD may be accompanied by gastrointestinal symptoms, such as diarrhea, abdominal pain, and extraintestinal symptoms caused by secondary malnutrition. Many studies have suggested that CD is associated with intestinal tumors such as enteropathy-associated T-cell lymphoma (EATL), small bowel cancer (SBC), and colorectal cancer. In this study, we reviewed related studies published in the literature to provide a reference for the prevention and treatment of intestinal tumors in patients with CD. Compared with the general population, CD patients had a high total risk of SBC and EATL, but not colorectal cancer. The protective effect of GFD on CD-related malignancies is controversial. Further studies are needed to confirm whether GFD treatment can reduce the risk of intestinal neoplasms in CD.
乳糜泻(CD)是一种具有遗传易感性的慢性免疫介导性肠道疾病。其特征是摄入含麸质蛋白的谷物和产品后小肠出现炎症性损伤。近年来,全球CD患病率约为1%,且呈逐渐上升趋势。CD患者需终生坚持无麸质饮食(GFD)。然而,严格坚持GFD很困难。未经治疗的CD可能伴有胃肠道症状,如腹泻、腹痛,以及由继发性营养不良引起的肠外症状。许多研究表明,CD与肠道肿瘤有关,如肠病相关T细胞淋巴瘤(EATL)、小肠癌(SBC)和结直肠癌。在本研究中,我们回顾了文献中发表的相关研究,为CD患者肠道肿瘤的防治提供参考。与普通人群相比,CD患者患SBC和EATL的总体风险较高,但患结直肠癌的风险不高。GFD对CD相关恶性肿瘤的保护作用存在争议。需要进一步研究来证实GFD治疗是否能降低CD患者肠道肿瘤的风险。