Risk of Ulcerative Colitis-Associated Colorectal Cancer in China: A Multi-Center Retrospective Study
Risk of Ulcerative Colitis-Associated Colorectal Cancer in China: A Multi-Center Retrospective Study
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DOI：
10.1007/s10620-011-1890-9
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发表时间：
2012-02-01
影响因子：
3.1
通讯作者：
Jiang, Bo
中科院分区：
文献类型：
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作者：
Gong, Wei;Lv, Nonghua;Jiang, Bo
在过去的10年里，中国的溃疡性结肠炎(UC)患者数量有所增加。因此，预计UC相关性结直肠癌(UC-CRC)的发病率也将增加。然而，UC患者发生结直肠癌的风险在中国仍是未知的。本研究旨在探讨结直肠癌的发病风险及危险因素。本研究从1998年至2009年间收集了中国5所中心教学医院收治的3,922例结直肠癌患者，这些医院均有高质量的胃镜及组织学诊断。对UC和UC相关的结直肠癌患者数据库进行评估，确诊为结直肠癌34例，结直肠癌的总患病率为0.87%。病程10年后发生结直肠癌的累积风险为1.15%(95%可信区间0.71~1.84%)，20年3.56%(95%可信区间2.14~5.89%)，30年14.36%(95%可信区间7.57~26.3%)。病程较长、广泛的结肠炎和活检标本中发现的异型增生被确定为发展为结直肠癌的危险因素。5-ASA的使用是UC-CRC的保护因素。结直肠癌患病率低于西方报道。然而，累积风险被发现与西方国家相当，这表明中国未来UC-CRC的时期患病率可能会上升。
The number of patients with ulcerative colitis (UC) in China has increased in the past 10 years. Thus, it is anticipated that the incidence of UC-associated colorectal cancer (UC-CRC) will also increase. However, the risk of CRC in UC patients is still unknown in Chinese. The aim of this study was to identify the risk and risk factors of UC-CRC in Chinese.A total of 3,922 patients with UC were retrospectively collected from five central teaching hospitals in China, in which high-quality endoscopic and histological diagnoses were available from 1998 to 2009. The database of the UC and UC-associated CRC patients was evaluated.CRC was diagnosed 34 in patients, and the overall prevalence of CRC in patients with UC was 0.87%. The cumulative risk of developing CRC after a disease duration of 10 years was 1.15% (95% confidence interval [CI] 0.71-1.84%); 20 years, 3.56% (95% CI 2.14-5.89%); and 30 years, 14.36% (95% CI 7.57-26.3%). Longer disease duration, extensive colitis, and dysplasia found in the biopsy specimen were identified as risk factors for developing CRC. 5-ASA use was identified as a protective factor of UC-CRC.The period prevalence of CRC was lower than that reported from the West. However, the cumulative risk was found to be comparable to that of Western countries, which suggests that the period prevalence of UC-CRC in China may be growing in the future.