溃疡性结肠炎的慢性炎症和恶性肿瘤

Ulcers Pub Date : 2011-04-20 DOI:10.1155/2011/714046
S. Sunkara, G. Swanson, C. Forsyth, A. Keshavarzian
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引用次数: 23

摘要

溃疡性结肠炎(UC)是一种慢性炎症性肠病(IBD),与多种结肠和肠外并发症相关,最严重的是结直肠癌(CRC)的发展。与一般人群相比,UC相关的结直肠癌风险增加。虽然UC中结直肠癌的发病机制尚不清楚,但大多数研究将其与长期炎症以及其他危险因素(如疾病持续时间、炎症程度、结直肠癌家族史以及原发性硬化性胆管炎(PSC)等共存疾病)联系起来。UC是一种终身疾病,患者需要警惕筛查,包括监测结肠镜检查以促进CRC的早期发现,但在监测结肠镜检查的成本效益和提高生存率方面存在一些争议。较新的方法,如色内窥镜、窄带成像、高清晰度结肠镜和共聚焦显微镜,有助于在监测结肠镜检查中开发更有针对性的早期检测不典型增生的方法。本文综述了慢性结肠炎症和发育不良在uc相关性结直肠癌发展中的作用,以及目前uc相关性结直肠癌的筛查、检测、化学预防和治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Chronic Inflammation and Malignancy in Ulcerative Colitis
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) associated with multiple colonic and extraintestinal complications, the most severe being the development of colorectal cancer (CRC). Compared to the general population, there is an increased risk of CRC associated with UC. Although the pathogenesis of CRC in UC is unknown, most studies have linked it to long-standing inflammation as well as other risk factors such as duration of disease, extent of inflammation, family history of CRC, and coexisting conditions such as primary sclerosing cholangitis (PSC). UC is a life-long disease for which patients enter a vigilant screening program which includes surveillance colonoscopy to promote early detection of CRC yet some controversies exist regarding the cost effectiveness of surveillance colonoscopy and improving survival. Newer modalities such as chromoendoscopy, narrow band imaging, high definition colonoscopy, and confocal microscopy have aided in developing a more targeted approach for early detection of dysplasia in surveillance colonoscopy. This review focuses on the role of chronic colonic inflammation and dysplasia in development of UC-associated CRC and current methods of screening, detection, chemoprevention, and treatment of UC-associated CRC.
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