Almási Szintia, Balajthy Zsófia, Baráth Bence, Török Zsófia Krisztina, Szaszák Panna, Lantos Tamás, Kővári Bence, Sejben Anita
Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.
Mass General Brigham, Harvard Medical School, Boston, MA, United States.
Pathol Oncol Res. 2025 Jan 3;30:1611978. doi: 10.3389/pore.2024.1611978. eCollection 2024.
Recently, several non-conventional variants of IBD-associated dysplasia have been described; however, their prevalence in Central-Eastern Europe is unknown. We aimed to perform a retrospective pilot study by re-evaluating several IBD-associated adenocarcinoma cases to survey the incidence of adjacent non-conventional dysplasia and validate that recent North American findings may apply to a European population.
Retrospectively, 28 randomly chosen cases of IBD-associated adenocarcinomas diagnosed between 2010 and 2022 were re-evaluated. The patient's sex, age (at the diagnosis of IBD and neoplasia), type of IBD, type of specimen [biopsy (n = 8)/surgical specimen (n = 20)], histological type, grade, localisation, stage, disease-free (DFS) and overall survival (OS) were obtained. Statistical analyses were carried out by using Mann-Whitney (continuous variables), Fisher's exact (categorical variables), Kaplan-Meier (DFS/OS curves), and logrank test (survival curves).
Exclusively, conventional dysplasia was observed in 11, and non-conventional dysplasia in 8 patients. Combined conventional and non-conventional dysplasia was detected in 9 patients. Non-conventional dysplasia showing a combination of multiple subtypes was noted in 10 cases. Altogether, 25 non-conventional dysplastic foci were identified, which were diagnosed as hypermucinous (n = 9), goblet cell-deficient (n = 6), serrated not otherwise specified (NOS) (n = 6), and traditional serrated adenoma-like (n = 4). The majority of non-conventional dysplasias were associated with ulcerative colitis (n = 12). Mucinous adenocarcinoma was exclusively associated with non-conventional dysplasia, while medullary carcinoma was only with conventional dysplasias ( and ).
Based on our results, non-conventional dysplasia is common (60%) adjacent to IBD-associated adenocarcinomas in a Central-Eastern European population and may be detected in biopsies. As multiple recent publications reported evidence of a worse prognosis and more common flat morphology compared to conventional dysplasias, their recognition is of great importance, and stricter follow-up with random biopsy samples may be considered.
最近，已经描述了几种与炎症性肠病（IBD）相关的发育异常的非传统变体；然而，它们在中东欧的患病率尚不清楚。我们旨在通过重新评估几例与IBD相关的腺癌病例进行一项回顾性试点研究，以调查相邻非传统发育异常的发生率，并验证最近北美的研究结果是否适用于欧洲人群。
回顾性地重新评估了2010年至2022年间随机选择的28例与IBD相关的腺癌病例。获取了患者的性别、年龄（IBD诊断时和肿瘤形成时）、IBD类型、标本类型[活检（n = 8）/手术标本（n = 20）]、组织学类型、分级、定位、分期、无病生存期（DFS）和总生存期（OS）。使用曼-惠特尼检验（连续变量）、费舍尔精确检验（分类变量）、卡普兰-迈耶检验（DFS/OS曲线）和对数秩检验（生存曲线）进行统计分析。
仅在11例中观察到传统发育异常，8例中观察到非传统发育异常。9例中检测到传统和非传统发育异常并存。10例中发现了显示多种亚型组合的非传统发育异常。总共鉴定出25个非传统发育异常病灶，诊断为高黏液性（n = 9）、杯状细胞缺乏性（n = 6）、未另行指定的锯齿状（NOS）（n = 6）和传统锯齿状腺瘤样（n = 4）。大多数非传统发育异常与溃疡性结肠炎相关（n = 12）。黏液腺癌仅与非传统发育异常相关，而髓样癌仅与传统发育异常相关（以及）。
根据我们的结果，在中东欧人群中，非传统发育异常在与IBD相关的腺癌附近很常见（60%），并且可能在活检中检测到。由于最近的多篇出版物报道了与传统发育异常相比预后更差且扁平形态更常见的证据，对它们的识别非常重要，可能需要考虑对随机活检样本进行更严格的随访。
