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炎症性肠病中恶性肿瘤的预测因素有哪些?

What are the predictors of malignancy in inflammatory bowel disease?

作者信息

Istemihan Zülal, Çavuş Bilger, Bardak Ali Emre, Kirkoğlu Ayşe Merve, Kiziltaş Cansu, Silay Rüveyda, Şenkal İbrahim Volkan, Imanov Ziya, Nuriyev Kenan, Rüstemzade Aynure, Genç Sezen, Güllüoğlu Mine, Çifcibaşi Örmeci Aslı, Demir Kadir, Beşişik Fatih, Kaymakoğlu Sabahattin, Akyüz Filiz

机构信息

Division of Gastroenterohepatology, Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkiye.

Department of Internal Medicine, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkiye.

出版信息

Turk J Med Sci. 2025 Apr 24;55(4):846-854. doi: 10.55730/1300-0144.6036. eCollection 2025.

Abstract

BACKGROUND/AIM: This study aims to investigate the prevalence of malignancy in patients with inflammatory bowel disease (IBD) followed up in a tertiary reference center.

MATERIALS AND METHODS

IBD patients with at least 6 months of follow-up from the gastroenterology clinic between 2000 and 2022 were evaluated retrospectively in a tertiary center. Patient information was obtained from the patient registration system.

RESULTS

There were 697 patients in the study, 320 (45.9%) of these were female. The mean age of the patients at IBD diagnosis was 33.4 ± 13.1 years. The mean follow-up time was 93.1 ± 64.8 (median 84, IQR (25-75) (36-144)) months. IBD types were as; 315 (45.2%) had ulcerative colitis, and 382 (54.8%) had Crohn's disease. Before the diagnosis of IBD, 10 patients (1.4%) had a history of malignancy. The prevalence of malignancy after the diagnosis of IBD was 13 (1.9%). There was a relationship between malignancy and older age, higher BMI, and female sex in survival analysis (p < 0.05). There was no correlation with disease type and malignancy (p = 0.820). When the patients who developed malignancy in IBD were compared in terms of the immunomodulators and biological agents used by the patients who did not develop malignancy, there was no statistical difference between the two groups (p > 0.05).

CONCLUSION

Older age, higher BMI, and female sex were found to be at risk for the development of malignancy in IBD, although no relationship was found with the use of immunomodulators, biological agents, or disease type.

摘要

背景/目的:本研究旨在调查在一家三级转诊中心接受随访的炎症性肠病(IBD)患者中恶性肿瘤的患病率。

材料与方法

对2000年至2022年间在胃肠病科门诊接受至少6个月随访的IBD患者在一家三级中心进行回顾性评估。患者信息从患者登记系统中获取。

结果

本研究中有697例患者,其中320例(45.9%)为女性。IBD诊断时患者的平均年龄为33.4±13.1岁。平均随访时间为93.1±64.8(中位数84,四分位数间距(25 - 75)(36 - 144))个月。IBD类型如下:315例(45.2%)患有溃疡性结肠炎,382例(54.8%)患有克罗恩病。在IBD诊断之前,10例患者(1.4%)有恶性肿瘤病史。IBD诊断后恶性肿瘤的患病率为13例(1.9%)。生存分析显示恶性肿瘤与年龄较大、体重指数较高和女性性别之间存在关联(p < 0.05)。与疾病类型和恶性肿瘤无相关性(p = 0.820)。当比较IBD中发生恶性肿瘤的患者与未发生恶性肿瘤的患者所使用的免疫调节剂和生物制剂时,两组之间无统计学差异(p > 0.05)。

结论

尽管未发现与免疫调节剂、生物制剂的使用或疾病类型有关,但发现年龄较大、体重指数较高和女性性别是IBD发生恶性肿瘤的危险因素。

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The four epidemiological stages in the global evolution of inflammatory bowel disease.炎症性肠病全球演变的四个流行病学阶段。
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Malignancies in Inflammatory Bowel Disease.炎症性肠病中的恶性肿瘤
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