潰瘍性大腸炎におけるがんの監視. 15年以上の経験があります

J E Lennard-Jones, B C Morson, J K Ritchie

Lancet (London, England)

|July 16, 1983

まとめ

潰瘍性大腸炎の患者さんの不形成症に対する定期的なモニタリングは極めて重要です. 早期発見と介入は,慢性大腸炎の症例において,大腸直腸がんのリスクを大幅に軽減します.

科学分野:

胃腸内科胃腸内科
腫瘍学腫瘍学
結腸直腸外科手術について

背景:

広範な潰瘍性大腸炎 (UC) は,結腸直腸癌のリスクを高めます.
長期にわたるUCは,がん前変化に対する注意深い監視を必要とします.

研究の目的:

広範な潰瘍性大腸炎の患者におけるディスプラスティック変化の検出における定期的な臨床評価と粘膜組織生検の有効性を評価する.
長期UC患者における不形成症と癌の発生率を決定し,患者のアウトカムに対する監視の影響を評価する.

主な方法:

放射線学的に広範な潰瘍性大腸炎を患った303人の患者のコホートは,1966年から1980年まで追跡されました.
ディスプラスティック変化を検出するために,定期的な臨床評価と粘膜生検が行われました.
疾患の持続時間,発育不全の度数,がんの発症など,患者のデータを分析した.

主要な成果:

中等度または重度の発育不全は,がんのない8人の手術を受けた患者で確認されました.
10年以上の病歴を有する186人の患者のうち13人にがんが発症した.
診断された16例のがんのうち11例は初期段階 (Dukes AまたはB) であり,1例の患者は15年以上にわたってがんにより死亡しました.

結論:

広範な潰瘍性大腸炎における不形成の定期的な監視は,がんの早期発見に不可欠です.
10年以上の広範な潰瘍性大腸炎を患っている患者は,プロクトコレクトミーまたは集中フォローアップを考慮する必要があります.
監視により,おそらく8例のがんが予防され,11例の患者の早期診断が可能になり,治癒可能性が向上した.

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