摘要
目的 探讨我国溃疡性结肠炎(UC)患者的地域分布情况、临床特点、癌变发生率、癌变危险因素及溃疡性结肠炎相关结直肠癌(UC-CRC)的治疗方法等现状.方法 回顾性纳入全国15所医院自2002年1月至2012年12月确诊的溃疡性结肠炎患者3 561例,收集并分析所有患者的性别、病程长短、病变范围、治疗措施、癌变率及预后等资料.根据是否发生结直肠癌变将溃疡性结肠炎患者分为癌变组和无癌变组,比较两组患者临床特点,分析结直肠癌变的危险因素.结果 3 561例溃疡性结肠炎患者中3 532例无结直肠癌变,29例发生结直肠癌变,总体癌变率为0.81% (29/3 561);其中17例病程达10年以上,23例为全结肠型溃疡性结肠炎.使用5-氨基水杨酸(5-ASA)治疗是溃疡性结肠炎患者发生癌变的保护性因素,而使用激素治疗与癌变的发生率无相关性.结论 我国溃疡性结肠炎患者有较高的结直肠癌变风险.病程长及病变范围广泛是溃疡性结肠炎发生结直肠癌变的两个相对独立的危险因素.使用5-ASA治疗是溃疡性结肠炎结直肠癌变的保护因素.
Objective To investigate the distribution,clinical features,canceration rate,canceration risk factors of ulcerative colitis(UC)patients,and the treatment of ulcerative colitis-associated colorectal cancer(UC-CRC)in China.Methods 3 561 patients diagnosed as UC at 15 domestic hospitals from January 2002 to December 2012 were retrospectively enrolled.Data of sex,disease duration,lesions range,treatment,canceration rate and prognosis from these patients were collected and analyzed.In addition,these patients were divided into colorectal cancer groups and non-cancerous groups and the risk factors of colorectal cancer could be analyzed by comparing clinical characters of these two groups.Results Colorectal cancer(CRC)was diagnosed in 29 of 3 561 patients with UC,and the prevalence of CRC in patients with UC was 0.81%(29/3 561).Among all the UC-CRC patients,17 patients had a disease duration of more than 10 years and 23 patients were diagnosed with extensive colitis.5-ASA therapy was identified as protective factor of cancerationin UC-CRC,while there was no correlation between steroids therapy and the prevalence of UC-CRC.Conclusions The cumulative risk of CRC is quite high in patients with UC in China.The disease duration more than 10 years and extensive colitis are two independent risk factors for developing CRC.Regular 5-ASA therapy can reduce the risk of UC-CRC.
作者
张琴
万健
吴开春
十二五”炎症性肠病癌变项目组
Zhang Qin;Wan Jian;Wu Kaichun(State Key Laboratory of Cancer Biology,Xijing Hospital of Digestive Diseases,The Fourth Military Medical University,Air Force Military Medical University,Xi′an 710032,China)
出处
《中华炎性肠病杂志（中英文）》
2017年第3期155-159,共5页
Chinese Journal of Inflammatory Bowel Diseases
关键词
溃疡性结肠炎
结直肠癌
中国
Ulcerative colitis
Colorectal cancer
China
