Lennard-Jones J E, Morson B C, Ritchie J K, Williams C B
Lancet. 1983 Jul 16;2(8342):149-52. doi: 10.1016/s0140-6736(83)90129-0.
In the years 1966-80, 303 patients with radiologically extensive ulcerative colitis were followed up regularly, both by clinical assessment and by mucosal biopsies, to detect dysplastic (precancerous) change. Moderate or severe dysplasia (but no carcinoma) was found in the specimen in 8 patients treated surgically. Despite regular surveillance, carcinoma developed in 13 of the 186 patients with a history of disease for ten years or more. Of the total sixteen carcinomas in these 13 patients, eleven were Dukes stage A, three stage B, one stage C, and one was inoperable. There has been 1 death from carcinoma in this series over the fifteen year observation period. The method of follow-up has probably prevented the development of carcinoma in 8 patients and permitted diagnosis of carcinoma at a stage when cure is likely in 11. The incidence of moderate or severe dysplasia and carcinoma in these patients with mild or symptomless extensive colitis shows that either proctocolectomy or careful follow-up should be advised once the duration of symptoms reaches ten years.
在1966年至1980年间，对303例经放射学检查确诊为广泛性溃疡性结肠炎的患者进行了定期随访，随访方式包括临床评估和黏膜活检，以检测发育异常（癌前）变化。在接受手术治疗的8例患者的标本中发现了中度或重度发育异常（但无癌变）。尽管进行了定期监测，但在186例病程达10年或更长时间的患者中，仍有13例发生了癌变。在这13例患者的16处癌变中，11例为Dukes A期，3例为B期，1例为C期，1例无法手术切除。在这15年的观察期内，该系列中有1例患者死于癌症。随访方法可能已防止8例患者发生癌变，并使11例患者在可能治愈的阶段被诊断出患有癌症。这些轻度或无症状广泛性结肠炎患者中中度或重度发育异常及癌变的发生率表明，一旦症状持续时间达到10年，应建议行直肠结肠切除术或进行仔细随访。
