Cancer risk in microscopic colitis: a retrospective cohort study
Cancer risk in microscopic colitis: a retrospective cohort study
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DOI：
10.1186/s12876-018-0926-4
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发表时间：
2019-01-05
影响因子：
2.4
通讯作者：
Ananthakrishnan, Ashwin N.
中科院分区：
文献类型：
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作者：
Levy, Alexander;Borren, Nienke Z.;Ananthakrishnan, Ashwin N.
显微镜下结肠炎（MC）（胶原性结肠炎（CC），淋巴细胞性结肠炎（LC））的长期自然病史，传统上被认为是复发但非进展性疾病，定义不清。这些疾病中持续的组织学炎症是否与结直肠瘤变（CRN）或结外癌的风险增加有关，目前还没有明确的证据。方法该回顾性队列包括在转诊中心诊断为MC的患者。使用来自监测、流行病学和最终结果（SEER）项目的数据，比较了接受筛查结肠镜检查的患者（n=306）和美国人群的CRN和结肠外癌发生率。计算标准化发病率比（SIR）和95%置信区间，并使用多变量回归模型确定MC诊断和严重程度对癌症风险的影响。结果本研究纳入221例显微镜下结肠炎患者（CC 112例，LC 109例），其中77%为女性。与结肠镜检查对照组相比，MC与管状腺瘤（比值比（OR） 1.07, 95% CI 0.69-1.66）或绒毛状腺瘤（OR 1.26, 95% CI 0.17-9.42）的发生率相似。与单次发作的MC患者相比，两次或两次以上发作的患者患结肠癌（or 0.83, 95% CI 0.20-3.39）或管状腺瘤（or 1.49, 95% CI 0.83-2.67）的风险相似。我们还发现，与US-SEER数据相比，MC人群的癌症发病率没有统计学上的增加。结论：与接受结肠镜检查的对照组或美国SEER人群相比，显微镜下结肠炎与CRN和结肠外癌的风险增加无关。
BackgroundThe long-term natural history of microscopic colitis (MC) (collagenous colitis (CC), lymphocytic colitis (LC)), traditionally considered relapsing but non-progressive diseases, is poorly defined. Whether persistent histologic inflammation in such diseases is associated with an increased risk of colorectal neoplasia (CRN) or extracolonic cancers has not been robustly established.MethodsThis retrospective cohort included diagnosed with MC at a referral center. Rates of CRN and extracolonic cancer were compared to patients undergoing screening colonoscopy (n=306) and to the United States population using data from the Surveillance, Epidemiology, and End-Results (SEER) program. Standardized incidence ratios (SIR) and 95% confidence intervals were calculated and multivariable regression models used to identify the effect of MC diagnosis and severity on cancer risk.ResultsOur study included 221 patients with microscopic colitis (112 CC, 109 LC) among whom 77% were women. Compared to the colonoscopy control population, MC was associated with similar odds of tubular adenoma (Odds ratio (OR) 1.07, 95% CI 0.69-1.66) or villous adenoma (OR 1.26, 95% CI 0.17-9.42). Compared to patients with a single episode of MC, those with 2 or more episodes had similar risk of colon cancer (OR 0.83, 95% CI 0.20-3.39) or tubular adenoma (OR 1.49 95% CI 0.83-2.67). We also identified no statistical increase in the rates of cancer in the MC population compared to US-SEER data.ConclusionMicroscopic colitis was not associated with increased risk of CRN and extracolonic cancers when compared to controls undergoing colonoscopy or the US SEER population.