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在炎症性肠病的设置中小肠癌
Himani Bhatt1, Kellie L Mathis1
1Department of Surgery, Mayo Clinic, Rochester, Minnesota.
Clinics in colon and rectal surgery
|January 8, 2024
概括
患有炎症性肠病 (IBD) 的患者患小肠癌的风险增加. 由于症状重叠,诊断具有挑战性,往往导致晚期检测和不良预后.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 小肠癌很少见,但发病率正在增加.
- 患有炎症性肠道疾病 (IBD) 的患者面临显著增加的风险,特别是克罗恩病患者 (增加12倍).
- 与一般人群相比,性结肠炎患者的风险增加率较为温和,有争议的2倍.
研究的目的:
- 审查目前对IBD患者小肠腺癌的理解.
- 突出诊断挑战和当前的治疗策略.
- 讨论与这些恶性瘤相关的不良预后.
主要方法:
- 对IBD中小肠腺癌现有文献的综述.
- 对诊断困难和成像局限性的分析.
- 评估当前的治疗模式,包括手术和化疗.
主要成果:
- 小肠癌IBD患者的非特异性症状与IBD症状重叠,使手术前诊断复杂化.
- 截面成像通常是非诊断性的,在IBD手术期间经常偶然发现癌症.
- 大多数病例在晚期被诊断出来,导致预后不佳.
结论:
- 在IBD患者中小肠腺癌存在重大诊断挑战.
- 瘤外科切除是局部区域性疾病的主要治疗方法.
- 预后仍然不佳,报告的长期存活率有限,这凸显了改善早期检测和管理策略的必要性.
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