在患有炎症性肠道疾病的患者中进行大肠切除术后的直肠癌风险 - 一项基于人口的丹麦队列研究 1978-2018年
Elena Akimenko1, Jacob Tveiten Bjerrum1, Aske Thorn Iversen2
1Department of Gastroenterology and Hepatology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
Gastro hep advances
|August 12, 2024
概括
患有炎症性肠病 (IBD) 的患者接受亚整体切除术,在手术后的10年内面临明显增加的直肠癌风险. 对这些人来说,加强长期监测至关重要. 这项研究强调了对集体化IBD患者更新查方案的需要.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 患有性结肠炎和克罗恩病的患者患结肠直肠癌的风险更高.
- 目前对结直肠癌的监测指南往往不包括经过结直肠切除术的患者.
- 需要了解在进行亚整体切除术后的炎症性肠病 (IBD) 患者的直肠癌的特定风险.
研究的目的:
- 为了估计患有IBD的患者在亚整体切除术后发展直肠癌的风险.
- 为了将这种风险与没有胆管切除术的IBD患者和普通人群进行比较.
主要方法:
- 通过使用丹麦的民事登记系统进行了一项基于全国人口的队列研究.
- 分析了1978年至2018年的数据.
- 考克斯回归分析用于评估结肠切除术后直肠转移患者的直肠癌风险.
主要成果:
- 截肠癌发生在0.9%的患者 (42/4931) 后,以转移直肠的亚总切除术.
- 切除术后10年,直肠癌的风险比率显著增加 (HR 7.56与没有切除术的IBD相比;HR 10.01与背景人群相比).
- 在大肠切除术后的10年之前,与对照组相比,风险没有显著增加.
结论:
- 在IBD患者的亚总切除术后10年,转移直肠的直肠癌的风险明显增加.
- 这一发现强调了改善和扩展IBD患者的长期监测策略的必要性.
- 目前的监测协议可能对这一高风险群体不够.
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