炎症性肠病的不典型增生和结直肠癌监测。

IF 3.8 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Samba Siva Reddy Pulusu, Ian C Lawrance
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引用次数: 18

摘要

炎症性肠病(IBD)患者发展为结直肠癌(CRC)的风险增加,这是一种毁灭性的并发症,肠道发育不良是其前兆。在确定IBD中结直肠癌的风险,鉴别和管理异常增生以及预防方法方面已经取得了相当大的进展。传统上,采用随机结肠活检的监测结肠镜检查。然而,最近的数据表明,色内窥镜检查是一种更好的监测方法。使用5-氨基水杨酸制剂主要用于化学预防是一个持续的争论,然而,当处方与其他策略一起控制炎症时,它们的使用被认为是有益的。本文综述了目前对肿瘤危险因素的认识,重点是不典型增生和预防策略。覆盖领域:PubMed搜索使用关键词来评估当前证据。随着遗传学,风险因素,策略,改变不典型增生的风险,并在IBD结直肠癌进行了详细讨论。专家评论:我们的策略在改变结直肠癌风险方面的作用需要进一步评估。未来的研究应致力于填补知识空白,如为色内窥镜检查提供高质量的证据和开发异常增生检测的分子标记。我们的最终目标是通过更好地了解IBD的关键致病机制来消除结直肠癌。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dysplasia and colorectal cancer surveillance in inflammatory bowel disease.

Introduction: Inflammatory bowel disease (IBD) patients are at an increased risk of developing colorectal cancer (CRC), a devastating complication of which intestinal dysplasia is the precursor. Considerable progress has been made to determine CRC risk in IBD, identification & management of dysplasia and preventative methods. Traditionally, surveillance colonoscopies with random colonic biopsies was used. However recent data suggests that chromoendoscopy is a better method of surveillance. Using 5-aminosalicylic acid agents primarily for chemoprevention is an ongoing debate however, when prescribed along with other strategies to control inflammation, their use is considered of benefit. This review presents current understanding of risk factors of neoplasia focusing on dysplasia and preventive strategies. Areas covered: PubMed search was done using key words to assess current evidence. Along with genetics, risk factors, strategies that modify the risk of dysplasia, and CRC in IBD are discussed in detail. Expert commentary: The role of our strategies in modifying CRC risk needs further assessment. Future research should aim to fill knowledge gaps such as high quality evidence for Chromoendoscopy and development of molecular markers for dysplasia detection. Our ultimate goal would be to eliminate CRC and is possible by better understanding of key pathogenic mechanisms in IBD.

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来源期刊
Expert Review of Gastroenterology & Hepatology
Expert Review of Gastroenterology & Hepatology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
6.80
自引率
2.60%
发文量
86
审稿时长
6-12 weeks
期刊介绍: The enormous health and economic burden of gastrointestinal disease worldwide warrants a sharp focus on the etiology, epidemiology, prevention, diagnosis, treatment and development of new therapies. By the end of the last century we had seen enormous advances, both in technologies to visualize disease and in curative therapies in areas such as gastric ulcer, with the advent first of the H2-antagonists and then the proton pump inhibitors - clear examples of how advances in medicine can massively benefit the patient. Nevertheless, specialists face ongoing challenges from a wide array of diseases of diverse etiology.
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