背景 粘膜炎症影响结肠直肠癌 性结肠炎的预后:全国性的多中心研究
Akiyoshi Ikebata1, Koji Okabayashi1, Motoi Uchino2
1Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
结直肠癌 (CRC) 的性结肠炎 (UC) 患者的背景炎症与更糟糕的结果有关. 在诊断时评估炎症可以改善UC中CRC的预后分层.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 炎症性肠道疾病研究研究
背景情况:
- 慢性背景粘膜炎是结肠直肠癌 (CRC) 在性结肠炎 (UC) 患者中发展的已知因素.
- 癌症诊断时这种炎症的预后意义仍然不清楚.
研究的目的:
- 调查癌症诊断期间记录的粘膜背景炎症是否会影响UC患者的瘤结果.
- 评估瘤位置与UC疾病程度和CRC预后之间的关联.
主要方法:
- 从日本全国的多中心数据库对1,189名被诊断为CRC的UC患者进行了回顾性分析.
- 根据诊断时的内镜检查结果,患者被分类为UC相关区域内的CRC或UC相关区域之外的CRC.
- 5年无复发存活率 (RFS) 和癌症特异性存活率 (CSS) 分别是主要和次要终点. 在区域内病例的炎症严重程度使用梅奥内镜评分 (MES) 进行分级.
主要成果:
- 在723名符合条件的患者中,683人患有UC所涉及区域内的CRC,40人患有UC外的CRC.
- 与区域外CRC (87.6%) 相比,区域内CRC (75.1%) 的五年RFS显著较低 (P=0.022).
- 瘤位于UC涉及区域内的位置是RFS的独立预后因素 (HR=2.99,P=0.030). 在5年CSS中也观察到显著差异 (P=0.038). 区域内案件中MES得分较高与RFS和CSS降低相关.
结论:
- 在CRC诊断时的粘膜背景炎症与UC患者的预后较差显著相关.
- 在癌症诊断过程中对炎症进行系统的内镜评估可以提高预后分层,并指导UC相关的CRC的临床管理策略.
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