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结直肠癌与炎症性肠病

Colorectal Cancer and Inflammatory Bowel Disease.

作者信息

Gamaleldin Maysoon, Qazi Taha, Hull Tracy

机构信息

Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio.

Department of Gastroenterology, Cleveland Clinic, Cleveland, Ohio.

出版信息

Clin Colon Rectal Surg. 2024 Jun 24;38(3):198-202. doi: 10.1055/s-0044-1787891. eCollection 2025 May.

Abstract

Colorectal cancer (CRC) in patients with ulcerative colitis (UC) and Crohn's disease accounts for ∼5% of all cases of CRC. Although it only accounts for a fraction of CRC cases, inflammatory bowel disease (IBD)-related CRC is a serious consequence of chronic inflammation that needs attention. There is a better understanding today about the pathogenesis contributing to IBD-CRC and the role of genetics and gut microbiota. Guidelines recommend timely screening and surveillance of UC and Crohn's patients, and it is usually timed from the initial diagnosis. This helps with early detection of dysplasia and CRC in this subset of patients, thus allowing for earlier intervention. However, dysplasia is not always easy to discern and management of CRC in each patient may differ. A multidisciplinary approach should be adopted in managing CRC in IBD. Although the oncologic principles of managing sporadic CRC and IBD-CRC are the same, surgical resection should be tailored to each patient.

摘要

溃疡性结肠炎(UC)和克罗恩病患者中的结直肠癌(CRC)占所有CRC病例的约5%。尽管它仅占CRC病例的一小部分,但炎症性肠病(IBD)相关的CRC是慢性炎症的严重后果,需要引起关注。如今,人们对导致IBD-CRC的发病机制以及遗传学和肠道微生物群的作用有了更好的理解。指南建议对UC和克罗恩病患者进行及时筛查和监测,通常从初次诊断开始计时。这有助于在此类患者亚组中早期发现发育异常和CRC,从而实现更早的干预。然而,发育异常并不总是容易辨别,并且每个患者的CRC管理可能有所不同。在IBD的CRC管理中应采用多学科方法。尽管管理散发性CRC和IBD-CRC的肿瘤学原则相同,但手术切除应根据每个患者进行调整。

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