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具有先前恶性瘤的炎症性肠病患者的结局
Uria Shani1, Eyal Klang2, Simon Lassman3
1Internal Medicine B, Sheba Medical Center, and Faculty of Medicine (Uria Shani).
炎症性肠病治疗可以增加癌症风险. 抗瘤坏死因子 (TNF) 治疗可能会增加非黑色素瘤皮肤癌 (NMSC) 的复发风险,在有恶性病史的IBD患者中.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 皮肤病学 皮肤病学
背景情况:
- 某些炎症性肠病 (IBD) 治疗方法,包括抗瘤缩因子 (TNF) 药物和氨酸,与特定癌症的更高风险有关.
- 对于有恶性瘤病史的IBD患者的治疗策略并不成熟,现有的文献有限.
研究的目的:
- 调查具有恶性病史的IBD患者的结局.
- 分析IBD患者在IBD特异性治疗前或期间恶性瘤复发或新癌症发展的风险.
主要方法:
- 在IBD诊断或治疗开始之前,已被诊断出至少一种恶性瘤的IBD成人患者的回顾性分析.
- 队列跟随在一个高等学术中心.
- 主要结局:以前恶性瘤的复发或第二次恶性瘤的发展.
主要成果:
- 在1112名患有恶性瘤的IBD患者中,86人 (9%) 符合纳入标准.
- 在这些患者中,10%的患者出现了第二次原发性恶性瘤.
- 23%的人经历了以前恶性瘤的复发,最常见的是非黑色素瘤皮肤癌 (NMSC) (45%).
- 治疗infliximab与NMSC复发有显著的相关性 (P=0.003).
结论:
- 抗TNF治疗可能会增加IBD患者NMSC复发的风险.
- 密切的皮肤病监测对有NMSC病史的IBD患者至关重要,这些患者正在接受抗TNF治疗.
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