Inflammatory bowel disease and cancer
Inflammatory bowel disease and cancer
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DOI：
10.1016/s0889-8553(05)70287-9
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发表时间：
1997-03-01
影响因子：
3.7
通讯作者：
Itzkowitz, SH
中科院分区：
文献类型：
--
作者：
Itzkowitz, SH
结肠直肠癌是长期患有溃疡性结肠炎和克罗恩病的患者的重要临床问题。传统的危险因素包括疾病持续时间长和结肠疾病的程度更大，但较新的因素，如相关的原发性硬化性胆管炎，叶酸缺乏症和结肠癌家族史可能有助于改善风险分层。结肠炎相关结肠癌的分子发病机制与散发性结肠癌有一些相同的遗传异常，但某些改变的时间表明不同的致癌途径。一些分子改变显示出作为发育异常的互补标记的希望。结肠镜监测的临床研究表明，结肠癌可以被早期发现，因此死亡率可能会降低。提出了一种建议的监测策略。
Colorectal cancer is a significant clinical problem for patients with long-standing ulcerative colitis and Crohn's disease. Traditional risk factors include long disease duration and greater extent of colonic disease, but newer factors such as associated primary sclerosing cholangitis, folate deficiency, and family history of colon cancer may help to refine risk stratification. Molecular pathogenesis of colitis-associated colon cancer shares some of the same genetic abnormalities as sporadic colon cancer, but the timing of certain alterations suggests different carcinogenic pathways. Some molecular alterations show promise as complementary markers to dysplasia. Clinical studies of colonoscopic surveillance indicate that colon cancers can be detected early and that mortality may therefore be improved. A suggested surveillance strategy is proposed.