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2021 年炎症性肠病患者的结直肠癌筛查和监测。

Colorectal cancer screening and surveillance in patients with inflammatory bowel disease in 2021.

机构信息

Department of Digestive Disease, General University Hospital of Valencia, Valencia 46014, Spain.

出版信息

World J Gastroenterol. 2022 Feb 7;28(5):502-516. doi: 10.3748/wjg.v28.i5.502.

Abstract

The detection of dysplasia in patients with inflammatory bowel disease (IBD) continues to be important given the increased risk of colorectal cancer in this population. Therefore, in 2017, we performed a review and update of the recommendations for the management and follow-up of patients with IBD based on the clinical practice guidelines of various scientific societies. The present manuscript focuses on new aspects of the detection, follow-up, and management of dysplasia according to the latest studies and recommendations. While chromoendoscopy with targeted biopsy continues to be the technique of choice for the screening and detection of dysplasia in IBD, the associated difficulties mean that it is now being compared with other techniques (virtual chromoendoscopy), which yield similar results with less technical difficulties. Furthermore, the emergence of new endoscopy techniques that are still being researched but seem promising (, confocal laser endomicroscopy and full-spectrum endoscopy), together with the development of devices that improve endoscopic visualization (, Endocuff Vision), lead us to believe that these approaches can revolutionize the screening and follow-up of dysplasia in patients with IBD. Nevertheless, further studies are warranted to define the optimal follow-up strategy in this patient population.

摘要

鉴于炎症性肠病(IBD)患者的结直肠癌风险增加,对其进行异型增生检测仍然很重要。因此,我们在 2017 年根据各个科学协会的临床实践指南,对 IBD 患者的管理和随访建议进行了回顾和更新。本文件重点介绍了根据最新研究和建议,对异型增生的检测、随访和管理的新方面。虽然靶向活检的 chromoendoscopy 仍然是 IBD 中筛查和检测异型增生的首选技术,但相关的困难意味着它现在正在与其他技术(虚拟 chromoendoscopy)进行比较,后者具有更少的技术困难但结果相似。此外,新的内镜技术正在研究中,这些技术似乎很有前途(共聚焦激光内镜和全光谱内镜),以及改善内镜可视化的设备(Endocuff Vision)的出现,使我们相信这些方法可以彻底改变 IBD 患者的异型增生筛查和随访。然而,仍需要进一步的研究来确定该患者人群的最佳随访策略。

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