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炎症性肠道疾病和结肠直肠癌
Jacopo Fanizza1, Sarah Bencardino1, Mariangela Allocca1
1Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, 20132 Milan, Italy.
Cancers
|September 14, 2024
概括
患有炎症性肠病 (IBD) 的患者患结直肠癌 (CRC) 的风险增加. 本综述更新了CRC流行病学,风险因素和IBD监测,为癌症IBD患者的管理提供了指导.
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:
- 患有炎症性肠道疾病 (IBD) 的患者,包括性结肠炎 (UC) 和克罗恩病 (CD),面临着更高的结直肠癌 (CRC) 风险.
- 最近内镜成像,监测计划和医疗疗法的进展,有助于IBD患者中CRC发病率的下降.
- 管理有IBD病史或活跃恶性瘤的IBD患者是一个重大的临床挑战,需要在癌症复发风险和因停药而导致IBD潜在恶化之间取得平衡.
研究的目的:
- 提供有关IBD患者CRC的流行病学,原因和风险因素的最新总结.
- 审查IBD患者中CRC目前的监测方法.
- 为IBD患者的管理提供实用指导,这些患者有癌症史或活跃癌症.
主要方法:
- 对IBD中CRC的流行病学数据,风险因素和监测策略的文献综述.
- 分析当前的医学疗法及其对IBD和癌症管理的影响.
- 综合证据,制定实际的临床指导.
主要成果:
- 虽然在IBD中CRC风险较高,但由于改善监测和治疗,发病率正在下降.
- 在IBD中CRC的关键风险因素包括疾病持续时间,程度和严重程度,以及原发性硬化胆道炎.
- 有效的管理策略包括在活跃或先前恶性瘤的背景下仔细考虑免疫抑制疗法.
结论:
- 持续的警和量身定制的监测对于在IBD患者中早期检测CRC至关重要.
- 对于患有并发或先前患有癌症的IBD患者来说,需要个性化管理计划,以平衡治疗有效性和安全性.
- 需要进一步的研究来优化IBD患者恶性瘤的管理,特别是关于免疫调节剂和生物药物的使用.
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