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克罗恩病中的小肠癌

Small Bowel Cancer in Crohn's Disease.

作者信息

Faggiani Ilaria, D'Amico Ferdinando, Furfaro Federica, Zilli Alessandra, Parigi Tommaso Lorenzo, Cicerone Clelia, Fiorino Gionata, Peyrin-Biroulet Laurent, Danese Silvio, Allocca Mariangela

机构信息

Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy.

IBD Unit, Department of Gastroenterology and Digestive Endoscopy, San Camillo-Forlanini Hospital, 00152 Rome, Italy.

出版信息

Cancers (Basel). 2024 Aug 21;16(16):2901. doi: 10.3390/cancers16162901.

Abstract

Crohn's disease (CD) is a chronic inflammatory bowel disease (IBD) that frequently affects the small bowel. Individuals diagnosed with CD are at increased risk of developing bowel cancer compared to the general population. Small bowel cancer is a rare but significant CD complication. Adenocarcinoma represents the most prevalent of these neoplasms, followed by neuroendocrine tumors and sarcomas. The primary risk factors identified are being of the male sex, disease duration, previous surgical intervention, perianal disease, and chronic inflammation. The precise etiology remains unclear. Another crucial issue concerns the role of immunomodulators and advanced therapies. By inhibiting inflammation, these therapies can reduce the risk of cancer, which is often initiated by the inflammation-dysplasia-adenocarcinoma sequence. In accordance with the most recent guidelines, it is not necessary to conduct surveillance in patients with small bowel cancer among CD patients, as it is considered a rare disease. Nevertheless, it is of significant importance for gastroenterologists to be aware of this potential CD complication, as well as the patients who are most at risk of developing it. The purpose of this review is to provide a comprehensive overview of CD-SBC, focusing on epidemiology, etiopathogenesis, risk factors, diagnosis, and the role of advanced therapies in CD-SBC.

摘要

克罗恩病(CD)是一种慢性炎症性肠病(IBD),常累及小肠。与普通人群相比,被诊断为CD的个体患肠癌的风险增加。小肠癌是一种罕见但严重的CD并发症。腺癌是这些肿瘤中最常见的,其次是神经内分泌肿瘤和肉瘤。已确定的主要风险因素包括男性、病程、既往手术干预、肛周疾病和慢性炎症。确切病因尚不清楚。另一个关键问题涉及免疫调节剂和先进疗法的作用。通过抑制炎症,这些疗法可以降低癌症风险,癌症通常由炎症-发育异常-腺癌序列引发。根据最新指南,对于CD患者中的小肠癌患者无需进行监测,因为它被认为是一种罕见疾病。然而,对于胃肠病学家来说,了解这种潜在的CD并发症以及最易发生该并发症的患者非常重要。本综述的目的是全面概述CD相关小肠癌(CD-SBC),重点关注其流行病学、病因发病机制、风险因素、诊断以及先进疗法在CD-SBC中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d266/11352503/9957d2372f95/cancers-16-02901-g001.jpg

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