Sciberras Nicole, Miruzzi Lara, Bugeja Luke, Gatt Adrienne, Cauchi Suzanne, Attard Zane, Ellul Pierre, Zammit Stefania Chetcuti
Department of Gastroenterology, Mater Dei Hospital, Msida, Malta (Nicole Sciberras, Lara Miruzzi, Luke Bugeja, Suzanne Cauchi, Pierre Ellul, Stefania Chetcuti Zammit).
Department of Medicine, Mater Dei Hospital, Msida, Malta (Adrienne Gatt, Zane Attard).
Ann Gastroenterol. 2025 Mar-Apr;38(2):182-186. doi: 10.20524/aog.2025.0952. Epub 2025 Feb 28.
Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is a multifactorial inflammatory disorder of the gastrointestinal system that impairs the patient's quality of life. Its presentation includes a spectrum of symptoms that may also be secondary to IBD complications, such as malignancy. On the other hand, immunosuppressive treatment to maintain remission also carries a risk of malignancy, which can cause patients distress due to the risk/benefit balance of IBD control and malignancy.
In this nationwide retrospective study, we aimed to elucidate which patient and treatment factors have the greatest impact on the development of malignancy in IBD patients. Statistical analysis was performed on patient factors, including treatment types, and nominal regression analysis was carried out to assess the effects of multiple risk factors on the incidence of malignancy in patients with IBD.
Age at diagnosis of IBD correlated significantly with malignancy development, as did the diagnosis of ulcerative colitis. IBD patients diagnosed with malignancy had an older age of onset of IBD than those who did not develop malignancy. Sex, treatment type, treatment duration, and extent or location of disease did not correlate significantly with malignancy development.
We conclude that age of onset of IBD plays the greatest role in malignancy development, whilst immunosuppressive treatment is not a significant risk factor.
炎症性肠病（IBD）包括克罗恩病和溃疡性结肠炎，是一种多因素引起的胃肠道炎症性疾病，会损害患者的生活质量。其表现包括一系列症状，这些症状也可能是IBD并发症（如恶性肿瘤）的继发症状。另一方面，维持缓解的免疫抑制治疗也有发生恶性肿瘤的风险，这会因IBD控制与恶性肿瘤的风险/获益平衡而使患者感到困扰。
在这项全国性回顾性研究中，我们旨在阐明哪些患者因素和治疗因素对IBD患者发生恶性肿瘤的影响最大。对包括治疗类型在内的患者因素进行了统计分析，并进行了名义回归分析，以评估多种风险因素对IBD患者恶性肿瘤发生率的影响。
IBD诊断时的年龄与恶性肿瘤的发生显著相关，溃疡性结肠炎的诊断也是如此。被诊断患有恶性肿瘤的IBD患者的IBD发病年龄比未发生恶性肿瘤的患者大。性别、治疗类型、治疗持续时间以及疾病的范围或部位与恶性肿瘤的发生没有显著相关性。
我们得出结论，IBD的发病年龄在恶性肿瘤发生中起最大作用，而免疫抑制治疗不是一个重要的风险因素。
