2001-2015年瑞典克罗恩病患者的结肠镜后直肠癌:基于人口的病例审查研究
Jessica Stjärngrim1, Anders Ekbom1, Linnea Widman2,3
1Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet.
European journal of gastroenterology & hepatology
|November 9, 2023
概括
克罗恩氏病 (CD) 患者的结肠直肠癌 (PCCRC) 在结肠镜检查后往往因为不充分的直肠检查而被遗漏. 改善监测遵守和直肠逆转对于早期检测和预防至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 结肠直肠癌查 结肠直肠癌查
背景情况:
- 结肠镜后结肠直肠癌 (PCCRC) 是一个关键的质量指标,在炎症性肠病 (IBD) 患者群体中观察到较高的发病率.
- 在这种情况下,直肠癌是克罗恩病 (CD) 患者PCCRC的重要风险因素,尚未得到广泛的研究.
研究的目的:
- 研究克罗恩病患者PCCRC的特征和根本原因.
- 分析在CD患者的结肠镜检查期间错过的直肠癌的因素.
主要方法:
- 在2001-2015年期间被诊断患有直肠癌的瑞典成年CD患者的回顾性审查.
- 使用世界内镜组织 (WEO) 标准对结肠镜记录进行根源原因分析和分类.
主要成果:
- 在24名患有PCCRC的CD患者中,63%患有远端直肠癌;仅报告了一例逆转.
- PCCRC的主要原因是"可能错过的病变" (63%),当考虑不充分的回归时,这一比例上升到77%.
- 非间隔类型C (54%) 和B (37%) 是最常见的,其中38%的C型癌症符合监测标准.
结论:
- 加强对监测指南的遵守和仔细的随访对于减少CD患者的PCCRC至关重要.
- 结肠镜检查期间的直肠触摸和逆转是关键的,应纳入WEO算法.
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