Maselli Roberta, de Sire Roberto, Massimi Davide, Franchellucci Gianluca, Busacca Anita, Castiglione Fabiana, Rispo Antonio, Hassan Cesare, Armuzzi Alessandro, Repici Alessandro
Gastroenterology, Endoscopy Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy.
Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy.
Diagnostics (Basel). 2023 Dec 20;14(1):9. doi: 10.3390/diagnostics14010009.
Patients suffering from inflammatory bowel disease (IBD) face a two to three-fold higher risk of developing colorectal cancer (CRC) compared to the general population. In recent years, significant progress has been made in comprehending the natural history of IBD-associated CRC (IBD-CRC) and refining its treatment strategies. The decreased incidence of IBD-CRC can be attributed to improved therapeutic management of inflammation, advancements in endoscopy, and early detection of precancerous lesions via surveillance programs. Advanced imaging technologies have made previously undetectable dysplasia visible in most cases, allowing for a much more precise and detailed examination of the mucosa. Additionally, new tools have facilitated the endoscopic resection (ER) of visible lesions in IBD. Particularly, the key to effectively manage colitis-associated colorectal neoplasia (CAN) is to first identify it and subsequently guarantee a complete ER in order to avoid surgery and opt for continuing surveillance. Advanced ER techniques for CAN include endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and hybrid ESD-EMR (h-ESD). This narrative review aims to consolidate the current literature on IBD-CRC, providing an overview of advanced techniques for ER of CAN in IBD, with a particular emphasis on the impact of ESD on the long-term outcomes of IBD patients.
与普通人群相比，炎症性肠病（IBD）患者患结直肠癌（CRC）的风险要高出两到三倍。近年来，在理解IBD相关结直肠癌（IBD-CRC）的自然病史以及完善其治疗策略方面取得了重大进展。IBD-CRC发病率的下降可归因于炎症治疗管理的改善、内镜检查技术的进步以及通过监测计划对癌前病变的早期发现。先进的成像技术使大多数情况下以前无法检测到的发育异常变得可见，从而能够对黏膜进行更精确、更详细的检查。此外，新工具促进了IBD中可见病变的内镜切除（ER）。特别是，有效管理结肠炎相关结直肠肿瘤（CAN）的关键是首先识别它，随后保证完整的ER，以避免手术并选择继续监测。CAN的先进ER技术包括内镜黏膜切除术（EMR）、内镜黏膜下剥离术（ESD）和ESD-EMR混合术（h-ESD）。本叙述性综述旨在整合关于IBD-CRC的现有文献，概述IBD中CAN的先进ER技术，特别强调ESD对IBD患者长期结局的影响。
