Mucosal dysplasia and DNA content in ulcerative colitis patients with ileorectal anastomosis
Mucosal dysplasia and DNA content in ulcerative colitis patients with ileorectal anastomosis
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溃疡性结肠炎回直肠吻合术患者粘膜发育不良及DNA含量
DOI：
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发表时间：
1991
影响因子：
3.9
通讯作者：
Åke Öst
中科院分区：
文献类型：
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作者：
R. Löfberg;C. Leijonmarck;O. Broström;Göran Hellers;Bernhard Tribukait;Åke Öst
在对1955年至1979年斯德哥尔摩郡确诊的1274名溃疡性结肠炎患者的流行病学定义的患者组的随访研究中，55名患者接受了结肠切除回肠直肠吻合术(IRA)。在对结肠切除标本进行组织病理学检查后，其中9人被发现患有克罗恩病。在46例仍待评估的溃疡性结肠炎患者中，有2例术后死亡。25例患者因顽固性炎症活动(n=22，1例术后死亡)或因异型增生(n=3)再次手术。在19名IRA在随访时仍完好无损的患者中，15名患者(中位病程23年)接受了灵活的乙状结肠镜检查并进行了多次活检。其余直肠和乙状结肠的平均长度为26厘米。无一例发现异常增生、癌或DNA异倍体。在最近一次常规乙状结肠镜检查时，其余四名患者均未发展为异型增生或癌。在这组选定的溃疡性结肠炎患者中，接受结肠切除术和来自流行病学定义的人群的IRA的恶变风险似乎很低。
In a follow-up study of an epidemiologically defined patient group comprising 1,274 patients with ulcerative colitis diagnosed in Stockholm County during 1955–1979, 55 patients had undergone colectomy with ileorectal anastomosis (IRA). Nine of these were found to have Crohn's disease after histopathologic review of the colectomy specimens. Of the 46 patients with ulcerative colitis remaining for evaluation, two died postoperatively. Twenty-five patients were subsequently reoperated with rectal excision owing to intractable inflammatory activity (n=22, one postoperative death) or owing to dysplasia (n=3). Of 19 patients with their IRA still intact at time of follow-up, 15 patients (median disease duration 23 years) had a flexible sigmoidoscopy with multiple biopsies performed. The average length of the remaining rectum and sigmoid colon was 26 cm. No patient had findings of dysplasia, carcinoma, or DNA aneuploidy. None of the four remaining patients had developed dysplasia or carcinoma at the time of the latest regular rigid sigmoidoscopy. The risk of malignant transformation in this selected group of patients with ulcerative colitis operated upon with colectomy and IRA derived from an epidemiologically defined population seems to be low.