Shaanxi University of Chinese Medicine, Xianyang.
Ankang Hospital of Traditional Chinese Medicine, Ankang.
Eur J Gastroenterol Hepatol. 2023 Oct 1;35(10):1075-1087. doi: 10.1097/MEG.0000000000002614. Epub 2023 Jul 31.
This study aims to assess the risk of colorectal stricture progressing to colorectal neoplasia (CRN) in patients with inflammatory bowel disease (IBD). The literature from PubMed, Embase, Web of Science, and Cochrane Library databases was searched from the date of databases' creation to 5 November 2022. The Newcastle-Ottawa Scale was used to evaluate the quality of the included literature. Meta-analysis was conducted using the Stata 15 software and R 4.04 software. Two case-control studies and 12 cohort studies were eventually included. Colorectal stricture in patients with IBD increased the risk of progressing to CRN [odds ratio (OR): 1.52, 95% confidence interval (CI): 1.02-2.29, P = 0.042], but was irrelevant to the risk of progressing to ACRN (OR: 3.56, 95% CI 0.56-22.70, P = 0.180). The risk of CRN were further distinguished in patients with ulcerative colitis (UC) and Crohn's disease (CD) Our findings showed that colorectal stricture may increase the risk of progressing to CRN in patients with UC (OR = 3.53, 95%CI 1.62-7.68, P = 0.001), but was irrelevant to the risk of progressing to CRN in patients with CD (OR = 1.09, 95% CI 0.54-2.21, P = 0.811). In conclusion, colorectal stricture in patients with IBD can be used as a risk factor for predicting CRN but cannot be used as a risk factor for predicting ACRN. Stricture is a risk factor for CRN in patients with UC but not in patients with CD. More prospective, multi-center studies with large samples are expected to confirm our findings.
本研究旨在评估炎症性肠病（IBD）患者结直肠狭窄进展为结直肠肿瘤（CRN）的风险。从数据库创建日期到 2022 年 11 月 5 日，检索了 PubMed、Embase、Web of Science 和 Cochrane Library 数据库中的文献。使用纽卡斯尔-渥太华量表评估纳入文献的质量。使用 Stata 15 软件和 R 4.04 软件进行荟萃分析。最终纳入了 2 项病例对照研究和 12 项队列研究。IBD 患者的结直肠狭窄增加了进展为 CRN 的风险[比值比（OR）：1.52，95%置信区间（CI）：1.02-2.29，P = 0.042]，但与进展为 ACRN 的风险无关（OR：3.56，95%CI 0.56-22.70，P = 0.180）。在溃疡性结肠炎（UC）和克罗恩病（CD）患者中进一步区分了 CRN 的风险。我们的研究结果表明，结直肠狭窄可能会增加 UC 患者进展为 CRN 的风险（OR = 3.53，95%CI 1.62-7.68，P = 0.001），但与 CD 患者进展为 CRN 的风险无关（OR = 1.09，95%CI 0.54-2.21，P = 0.811）。总之，IBD 患者的结直肠狭窄可作为预测 CRN 的危险因素，但不能作为预测 ACRN 的危险因素。狭窄是 UC 患者 CRN 的危险因素，但不是 CD 患者 CRN 的危险因素。预计将开展更多前瞻性、多中心、大样本研究来证实我们的研究结果。
