患有溃疡性结肠炎并伴有原发性硬化性胆管炎的患者患结直肠癌的风险是否更高？一项基于人群的研究。
Is there an excess risk for colorectal cancer in patients with ulcerative colitis and concomitant primary sclerosing cholangitis? A population based study.
作者信息
Kornfeld D, Ekbom A, Ihre T
机构信息
Department of Cancer Epidemiology, University Hospital, Uppsala, Sweden.
出版信息
Gut. 1997 Oct;41(4):522-5. doi: 10.1136/gut.41.4.522.
BACKGROUND
Patients with ulcerative colitis have an increased risk of colorectal cancer. Duration, age, and extent of the disease at diagnosis are the only established risk factors. Patients with ulcerative colitis and concomitant primary sclerosing cholangitis (PSC) have been reported to have a higher frequency of colonic DNA aneuploidy and/or dysplasia than expected, findings indicating an increased risk of colorectal cancer compared with other patients with ulcerative colitis.
METHODS
A population based cohort consisting of 125 patients with a verified diagnosis of PSC was followed up by linkage to the Swedish Cancer Registry for the occurrence of colorectal cancer.
RESULTS
There were 12 colorectal cancers. Six cancers were diagnosed prior to the diagnosis of PSC. Among the 104 patients with an intact colon at the time of the diagnosis of PSC there was a cumulative risk for colorectal cancer of 16% after 10 years. Among the 58 patients with a diagnosis of ulcerative colitis and colorectal cancer prior to the diagnosis of PSC, there were five colorectal cancers corresponding to a cumulative risk of 25% after 10 years.
CONCLUSIONS
Patients with ulcerative colitis and concomitant PSC seem to constitute a subgroup with a high risk for colorectal cancer.
背景
溃疡性结肠炎患者患结直肠癌的风险增加。病程、诊断时的年龄和疾病范围是仅有的已确定的风险因素。据报道，溃疡性结肠炎合并原发性硬化性胆管炎（PSC）的患者结肠DNA非整倍体和/或发育异常的发生率高于预期，这些发现表明与其他溃疡性结肠炎患者相比，其患结直肠癌的风险增加。
方法
通过与瑞典癌症登记处建立联系，对125例确诊为PSC的人群队列进行随访，以观察结直肠癌的发生情况。
结果
共发生12例结直肠癌。6例癌症在PSC诊断之前被确诊。在诊断PSC时结肠完整的104例患者中，10年后患结直肠癌的累积风险为16%。在诊断PSC之前被诊断为溃疡性结肠炎和结直肠癌的58例患者中，有5例结直肠癌，10年后的累积风险为25%。
结论
溃疡性结肠炎合并PSC的患者似乎构成了一个患结直肠癌风险较高的亚组。
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