与炎症性肠病相关的结直肠癌和发育不良的类型

H. Almottowa, A. Alkhars, Maram Hussam Hassan, Hamad Alhamad, S. Alshammari, Anas Adel Bahamdeen, T. Ladnah, Yousef Thalib Alalyani, Ahmed Taher Al binmaan, Sultan Ali Alajam, Ahmed Abdullah Alzooabi
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引用次数: 0

摘要

溃疡性结肠炎(UC)和克罗恩病(CD)是两种主要的肠壁炎症性疾病,统称为炎症性肠病(IBD)。结直肠癌(CRC)是IBD最显著和最严重的后果,在大多数病例中,结直肠癌之前都有发育不良。在这篇综述中,我们的目的是讨论由IBD引起的结直肠癌患者的各种类型的不典型增生。在PubMed, b谷歌Scholar等在线数据库中进行了彻底的文献检索,其中包括近十年发表的所有研究。诊断程序和可视化方式的主要发展有助于我们对非典型增生的理解,它现在被认为是CRC发展的最强预测和标记。然而,异常发育的不可预测的行为和进展仍然需要警惕的监视。不良发育根据组织学特征进行分类,使用不良发育等级从“不良发育阴性”到“高度不良发育”。通过内窥镜从“可见的不典型增生”到“不可见的不典型增生”,以及“常规的不典型增生”和“非常规的不典型增生”的宏观特征。没有单一的分类可以用来定义发育不良的分期,更重要的是预测其进展和结直肠癌的结局。利用循证医学,必须由一个专家小组制定一种扩展管理算法的综合分类,以指导疾病的管理。多学科、量身定制的方法,强调定期和及时的监测,以确保早期发现结直肠癌,可以提高生活质量和患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Types of colorectal cancer and dysplasia associated with inflammatory bowel disease
Ulcerative colitis (UC) and Crohn’s disease (CD) are two major inflammatory disorders of the intestinal wall collectively known as inflammatory bowel disease (IBD). Colorectal carcinoma (CRC) is the most significant and grave consequence of IBD and is preceded by dysplasia in majority of the cases. In this review we aim to discuss the various types of dysplasia found in patients with CRC due to IBD. A thorough literature search was conducted in online databases such as PubMed, Google Scholar, from which all studies published in the last ten years were included in this review. The major development in diagnostic procedures and visualization modalities have aided our understanding of dysplasia, which is now known to be the strongest predictor and marker for CRC development. However, the unpredictable behavior and progression of dysplasia still warrants vigilant surveillance. Dysplasia has been classified on histological characteristics using grades of dysplasia from ‘negative for dysplasia’ to ‘high grade dysplasia’. On visibility via an endoscope from ‘visible dysplasia’ to ‘invisible dysplasia’ and macroscopic features of ‘conventional dysplasia’ and ‘non-conventional dysplasia’. No single classification can be utilized to define the stage of dysplasia and more importantly predict its progression and outcome of CRC. Using evidence-based medicine an integrated classification expanding on a management algorithm must be formulated by a panel of experts to steer management of the disease. A multidisciplinary, tailored approach with a strong emphasis on regular and timely surveillance to ensure early detection of CRC can enhance quality of life and patient outcomes.
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