Age at diagnosis of inflammatory bowel disease influences early development of colorectal cancer in inflammatory bowel disease patients: a nationwide, long-term survey.
Age at diagnosis of inflammatory bowel disease influences early development of colorectal cancer in inflammatory bowel disease patients: a nationwide, long-term survey.
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DOI：
10.1007/s00535-012-0603-2
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发表时间：
2012-12
影响因子：
6.3
通讯作者：
van der Woude, C. J.
中科院分区：
文献类型：
--
作者：
Baars, J. E.;Kuipers, E. J.;van Haastert, M.;Nicolai, J. J.;Poen, A. C.;van der Woude, C. J.
关于炎症性肠病（IBD）相关结直肠癌（CRC）患者临床特征的数据很少，并且主要来自三级转诊中心。我们在全国综合医院的 IBD 队列中研究了 IBD 相关 CRC 的患者和疾病特征。主要结果参数是发生 CRC 的时间以及与早期 CRC 发生相关的因素。 1990 年 1 月 1 日至 2006 年 7 月 1 日期间诊断为 CRC 的所有 IBD 患者均使用全国自动化病理数据库 (PALGA) 进行识别。评估患者图表以确认诊断并收集临床数据。早期 CRC 定义为 IBD 诊断后不到 8 年诊断出 CRC。使用描述性统计、独立t检验、二元逻辑回归和Cox回归分析进行统计分析。 251 名患者（171 名溃疡性结肠炎、77 名克罗恩病、3 名未分类结肠炎）确诊为 IBD 相关 CRC，其中 161 名男性 (64%)。从 IBD 诊断到 CRC 诊断的中位时间为 12 年 (IQR 4-20)； 89 名患者 (35%) 出现早期结直肠癌。 IBD 类型、性别、合并的 PSC、假息肉、炎症程度和药物使用与早期 CRC 无关 (p > 0.05)。老年 IBD 诊断（10 岁以上的 HR 为 2.25；95% CI 1.92–2.63）与早期 CRC 相关。在 CRC 诊断之前，有 23 名患者 (12%) 已被纳入监测计划。监测组患者的肿瘤分期明显更好 (p = 0.004)。我们强调在建议开始监测之前，大量 IBD 相关 CRC 已发生的问题。因此，我们建议 IBD 发病年龄较大可能是开始对 IBD 患者进行监测的另一个因素。
Data on clinical characteristics of patients with inflammatory bowel disease (IBD)-related colorectal cancer (CRC) are scarce and mainly originate from tertiary referral centres. We studied patient and disease characteristics of IBD-related CRC in a nationwide IBD cohort in general hospitals. Main outcome parameters were time to develop CRC, and factors associated with early CRC development. All IBD patients diagnosed with CRC between 1 January 1990 and 1 July 2006 were identified using a nationwide automated pathology database (PALGA). Patient charts were assessed to confirm diagnosis and collect clinical data. Early CRC was defined as CRC diagnosed less than 8 years after IBD diagnosis. Statistical analysis was performed using descriptive statistics, independent t tests, binary logistic regression and Cox-regression analysis. Diagnosis of IBD-related CRC was confirmed in 251 patients (171 ulcerative colitis, 77 Crohn’s disease, 3 unclassified colitis), 161 males (64 %). Median time from IBD diagnosis to CRC diagnosis was 12 years (IQR 4–20); 89 patients (35 %) developed early CRC. Type of IBD, gender, concomitant PSC, pseudopolyps, extent of inflammation, and medication use were not related to early CRC (p > 0.05). IBD diagnosis at older age (HR for 10 years older age 2.25; 95 % CI 1.92–2.63) was related to early CRC. Twenty-three patients (12 %) had been included in a surveillance programme prior to CRC diagnosis. Patients in the surveillance group had a significantly better tumor stage (p = 0.004). We emphasize the problem of a high proportion of IBD-associated CRCs developing before the recommended start of surveillance. Therefore, we suggest that older age at IBD onset could be an additional factor to start surveillance in IBD patients.
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影响因子：
24.5
作者：
Lutgens, M. W. M. D.;Vleggaar, F. P.;Samsom, M.
通讯作者：
Samsom, M.
影响因子：
29.4
作者：
Askling, J;Dickman, PW;Ekbom, A
通讯作者：
Ekbom, A
影响因子：
1.9
作者：
Brackmann, Stephan;Andersen, Solveig N.;Vatn, Morten H.
通讯作者：
Vatn, Morten H.
影响因子：
29.4
作者：
Brentnall, TA;Haggitt, RC;Rubin, CE
通讯作者：
Rubin, CE
影响因子：
13.5
作者：
BROOME, U;LOFBERG, R;ERIKSSON, LS
通讯作者：
ERIKSSON, LS