在加泰罗尼亚进行的结直肠癌人群筛查中诊断出的无症状炎症性肠病：特征与自然史

Asymptomatic Inflammatory Bowel Disease Diagnosed During Colorectal Cancer Population Screening in Catalonia: Characteristics and Natural History.

作者信息

Brunet-Mas Eduard, Selva Anna, Bas-Cutrina Francesc, Brujats Anna, Caballol Berta, Font Rebeca, Gómez Bàrbara, Gonzalez-Muñosa Carlos, Busquets David, Monfort David, Vera Diana Patrícia, Maristany Elisabet, Cirera Gemma, Torres Gisela, Castro-Poceiro Jesús, Lopez Joel, Gonzalez-Gonzalez Laura, Màrquez-Mosquera Lucia, Gallach Marta, Esteve Maria, Tremosa Gemma, Torra Sandra, Robles-Alonso Virginia, Garcia-Iglesias Pilar, Rodríguez-Lago Iago, Calvet Xavier

机构信息

Gastroenterlogy Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain.

Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.

出版信息

Clin Transl Gastroenterol. 2025 Feb 1;16(2):e00740. doi: 10.14309/ctg.0000000000000740.

DOI:10.14309/ctg.0000000000000740

PMID:39729123

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11845185/

Abstract

INTRODUCTION

Inflammatory bowel disease (IBD) is usually diagnosed when symptomatic. Prognosis and evolution of preclinical IBD is largely unknown. However, colorectal cancer screening programs (CRCSP) detect a subset of patients with IBD with no symptoms. The aim of this study was to describe the natural history of asymptomatic IBD diagnosed through CRCSP.

METHODS

An observational, longitudinal, and retrospective study was performed at 22 centers in Catalonia between January 2010 and December 2019 including patients with asymptomatic IBD detected in the CRCSP. Demographic data and IBD characteristics, evolution, and treatment were recorded. Descriptive statistics and Kaplan-Meier analysis were used for the analysis. Data were given separately for IBD, Crohn's disease (CD), ulcerative colitis (UC), and IBD unclassified (IBDU).

RESULTS

One hundred eighty-eight patients were included: 103 UC (54.8%), 60 CD (31.9%), and 25 IBDU (13.3%). Sixty-six (35.1%) were women, and the average age was 59.9 ± 5.9 years. Sixty-four patients (34.0%) developed symptoms after a median follow-up of 35.6 months. Diarrhea was the most frequent symptom for CD and IBDU (25.4% and 11.5%, respectively) and blood in stools for UC (21.4%). The median time to first symptom was 11.6 months. Treatment was prescribed in 135 patients (72.2%); mesalazine was the most prescribed drug (123 patients; 65.4%). Thirteen patients (6.9%) required biological treatment. None underwent surgery.

DISCUSSION

Around one-third of asymptomatic patients with IBD developed symptoms after a medium follow-up of 3 years. Only 6.9% required biological treatment, and none required surgery. Overall, prognosis of asymptomatic IBD seems better.

摘要

引言

炎症性肠病（IBD）通常在出现症状时被诊断出来。临床前IBD的预后和演变情况在很大程度上尚不清楚。然而，结直肠癌筛查项目（CRCSP）能检测出一部分无症状的IBD患者。本研究的目的是描述通过CRCSP诊断出的无症状IBD的自然病史。

方法

2010年1月至2019年12月期间，在加泰罗尼亚的22个中心进行了一项观察性、纵向和回顾性研究，纳入了在CRCSP中检测出的无症状IBD患者。记录了人口统计学数据以及IBD的特征、演变情况和治疗情况。采用描述性统计和Kaplan-Meier分析进行分析。数据分别按IBD、克罗恩病（CD）、溃疡性结肠炎（UC）和未分类的IBD（IBDU）列出。

结果

共纳入188例患者：103例UC（54.8%），60例CD（31.9%），25例IBDU（13.3%）。66例（35.1%）为女性，平均年龄为59.9±5.9岁。中位随访35.6个月后，64例患者（34.0%）出现症状。腹泻是CD和IBDU最常见的症状（分别为25.4%和11.5%），便血是UC最常见的症状（21.4%）。首次出现症状的中位时间为11.6个月。135例患者（72.2%）接受了治疗；美沙拉嗪是最常用的药物（123例患者；65.4%）。13例患者（6.9%）需要生物治疗。无人接受手术。