结肠镜后结肠直肠癌在炎症性肠病中的可预防的预测因素
Elena De Cristofaro1,2, Irene Marafini1, Roberto Mancone2
1Gastroenterology Unit, Policlinico Universitario Tor Vergata, Rome, Italy.
Journal of Crohn's & colitis
|July 24, 2024
概括
结肠镜后结肠直肠癌 (PCCRC) 在炎症性肠病 (IBD) 患者中更为常见. 不充分的肠道准备和高风险因素增加了PCCRC风险,而免疫抑制剂和随机活检可能会降低PCCRC风险.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 结肠直肠癌研究研究
背景情况:
- 结肠镜后结肠直肠癌 (PCCRC) 是在结肠镜检查结果呈阴性后诊断出来的.
- 虽然PCCRC的发病率总体较低,但与普通人群相比,炎症性肠病 (IBD) 患者的发病率更高.
- 影响IBD相关PCCRC的因素需要确定.
研究的目的:
- 为了确定与IBD相关的PCCRC相关的指数结肠镜相关因素和患者特征.
- 了解IBD中PCCRC的特定风险和保护因素.
主要方法:
- 对在2010-2023年期间诊断的IBD相关PCCRC进行观察性,回顾性研究.
- 将PCCRC病例与没有CRC的IBD患者的1:1匹配对照队列进行比较.
- 匹配标准包括人口统计学,临床特征和指标结肠镜特征,以尽量减少偏差.
主要成果:
- 在研究人群中,超过50%的确定的结直肠癌 (CRC) 是PCCRC (37/61).
- 不充分的肠道准备 (OR:5.9) 和高危CRC因子 (OR:24.03) 独立地与PCCRC相关.
- 以前的免疫抑制剂/生物使用 (OR:0.17) 和随机活检 (OR:0.19) 显示与PCCRC的反向关联.
结论:
- 这一IBD队列中超过一半的结肠直肠癌是结肠镜检查后的结肠直肠癌.
- 在索引结肠镜检查期间肠道准备不足和患者高风险状态是PCCRC发展的重要因素.
- 免疫抑制疗法和随机活检可以在IBD患者中提供对PCCRC的保护作用.
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