Colorectal cancer in patients with inflammatory bowel disease after liver transplantation for primary sclerosing cholangitis.
Colorectal cancer in patients with inflammatory bowel disease after liver transplantation for primary sclerosing cholangitis.
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DOI：
10.1097/01.tp.0000058744.34965.38
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发表时间：
2003-06-27
期刊：
影响因子：
6.2
通讯作者：
Mirza, DF
中科院分区：
文献类型：
--
作者：
Vera, A;Gunson, BK;Mirza, DF
背景原发性硬化性胆管炎（PSC）和炎症性肠病（IBD）患者在肝移植（LT）后发生结直肠癌（CRC）的风险可能会增加。我们对肝移植后的PSC患者进行评估，以确定CRC的危险因素及其对生存率的影响。患者152在1986年至2000年5月期间，对173例接受LT的PSC患者（108例男性，100例IBD患者）进行了三组分析：（1）无IBD的PSC（n=52）;（2）行结肠切除术的PSC（LT前和LT时）（n=17，13例LT前结肠切除术和4例LT时同时结肠切除术）;和（3）患有IBD和完整结肠的PSC（n=83）。研究了以下因素：年龄、性别、肝肾生化、国际标准化比值、Child-Pugh分期、手术时间、血液使用、住院时间、免疫抑制、CRC风险、再次移植率和死亡率。LT后CRC的发生率为5.3%（8/152），而非PSC病例的发生率为0.6%（7/1，184）（P
Background. Patients with primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) may have an increased risk of developing colorectal cancer (CRC) after liver transplantation (LT). We evaluated our patients with PSC after LT to identify risk factors for CRC and its impact on survival.Patients and Methods. A total of 152 patients (108 men, 100 with IBD) with PSC who underwent 173 LTs between 1986 and May 2000 were analyzed in three groups: (1) PSC without IBD (n=52); (2) PSC with colectomy (pre-LT and at LT) (n=17, colectomy pre-LT in 13 and simultaneous colectomy at LT in four); and (3) PSC with IBD and an intact colon (n=83). The following factors were studied: age, gender, liver, and renal biochemistry, international normalized ratio, Child-Pugh stage, operative time, blood use, hospital stay, immunosuppression, risk of CRC, retransplantation rate, and mortality.Results. The incidence of CRC after LT was 5.3% (8/152) compared with 0.6% (7/1,184) in non-PSC cases (P