van Heerden J A, Beart R W
Dis Colon Rectum. 1980 Apr;23(3):155-9. doi: 10.1007/BF02587618.
Patients with pancolonic chronic ulcerative colitis are at increased risk to develop carcinoma of the colon. Controversy continues, however, as to whether this carcinoma is more "virulent" than "type ordinaire" carcinoma of the colon and as to the best way to manage these patients. This study reviews the characteristics and survival of 70 patients with cancer of the colon superimposed on chronic ulcerative colitis. Patients with carcinoma identified incidentally during prophylactic colectomy for chronic ulcerative colitis fared well (5-year survival of 72 per cent), while those with clinical symptoms or radiographic suggestion of cancer had a poor survival rate (5-year survival of 35 per cent). Patients with panproctocolitis, 10 years of disease, and early onset of disease are most likely to have cancer superimposed on chronic ulcerative colitis. This cancer is likely to have a poorer prognosis than type ordinaire cancer of the colon. Prophylactic proctocolectomy should be considered before evidence suggesting carcinoma develops.
全结肠型慢性溃疡性结肠炎患者患结肠癌的风险增加。然而，关于这种癌是否比结肠“普通型”癌更具“侵袭性”以及如何最佳治疗这些患者，仍存在争议。本研究回顾了70例慢性溃疡性结肠炎合并结肠癌患者的特征及生存情况。在因慢性溃疡性结肠炎行预防性结肠切除术时偶然发现的癌患者预后良好（5年生存率为72%），而有癌症临床症状或影像学提示的患者生存率较差（5年生存率为35%）。全直肠结肠炎患者、病程10年以及疾病早期发病者最有可能在慢性溃疡性结肠炎基础上合并癌症。这种癌的预后可能比结肠普通型癌更差。在有提示癌症发生的证据之前，应考虑行预防性直肠结肠切除术。
