Division of Gastroenterology and Hepatology, Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA.
Kaiser Permanente Northern California Division of Research, Oakland, California, USA.
Am J Gastroenterol. 2023 Aug 1;118(8):1453-1456. doi: 10.14309/ajg.0000000000002291. Epub 2023 Apr 11.
Occult colorectal cancer (CRC) has historically driven recommendations for colectomy in patients with inflammatory bowel disease with dysplasia . We defined the contemporary risk of occult CRC at colectomy among 93 patients with inflammatory bowel disease with dysplasia based on endoscopic appearance, resection, and concordance between site of cancer at colectomy and dysplasia at colonoscopy. Contrary to our hypothesis, we found that occult CRC at colectomy remains elevated in high-grade polypoid and invisible dysplasia. It was infrequent in other visible lesions. When present, occult cancer occurred in the same segment as dysplasia, suggesting the historic concern of missing a remote cancer is low.
隐匿性结直肠癌（CRC）一直以来都促使人们建议对有异型增生的炎症性肠病患者进行结肠切除术。我们根据内镜表现、切除情况以及结肠切除术时癌症部位与结肠镜下异型增生部位的一致性，在 93 例有异型增生的炎症性肠病患者中定义了隐匿性 CRC 的当代风险。与我们的假设相反，我们发现，在高级别息肉状和不可见异型增生中，结肠切除术后的隐匿性 CRC 仍然较高。在其他可见病变中则不常见。当存在时，隐匿性癌发生在与异型增生相同的节段，这表明既往对遗漏远处癌症的担忧较低。
