Lindberg B, Persson B, Veress B, Ingelman-Sundberg H, Granqvist S
Dept. of Diagnostic Radiology, Huddinge University Hospital, Sweden.
Scand J Gastroenterol. 1996 Dec;31(12):1195-204. doi: 10.3109/00365529609036910.
Endoscopic cancer surveillance in patients with ulcerative colitis has been performed for almost 3 decades. There is still no consensus on its clinical value.
This study evaluates a 20-year prospective study of 143 patients with extensive ulcerative colitis and a disease duration exceeding 10 years. Colonoscopy with double biopsy specimens from nine locations of the colon was performed every 2nd year. Biopsy specimens showing dysplasia were reviewed at the end of the study.
Through the surveillance dysplasia/cancer was detected in 55 patients; 7 of these patients had carcinomas, and 2 were in a possibly curable stage (Dukes A). The predictive value of low-grade dysplasia for either high-grade dysplasia or cancer was 41%.
Although impaired by limiting factors, colonoscopic surveillance of chronic extensive colitis may identify patients with dysplasia and thereby prevent malignant transformation.
溃疡性结肠炎患者的内镜癌症监测已开展近30年。但其临床价值仍未达成共识。
本研究评估了一项针对143例广泛性溃疡性结肠炎且病程超过10年患者的20年前瞻性研究。每两年进行一次结肠镜检查，并从结肠九个部位获取双份活检标本。在研究结束时对显示发育异常的活检标本进行复查。
通过监测，在55例患者中检测到发育异常/癌症；其中7例患者患有癌症，2例处于可能治愈阶段（杜克A期）。低度发育异常对高度发育异常或癌症的预测价值为41%。
尽管受到限制因素的影响，但对慢性广泛性结肠炎进行结肠镜监测可能识别出发育异常患者，从而预防恶性转化。
