HAZARD RATES FOR DYSPLASIA AND CANCER IN ULCERATIVE-COLITIS - RESULTS FROM A SURVEILLANCE PROGRAM
HAZARD RATES FOR DYSPLASIA AND CANCER IN ULCERATIVE-COLITIS - RESULTS FROM A SURVEILLANCE PROGRAM
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DOI：
10.1007/bf01537106
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发表时间：
1989-10-01
影响因子：
3.1
通讯作者：
HANAUER, SB
中科院分区：
文献类型：
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作者：
LASHNER, BA;SILVERSTEIN, MD;HANAUER, SB
溃疡性结肠炎患者患结肠癌的风险降低到疾病的持续时间和程度。先前的报告表明，儿童期发病的患者患癌症的风险很高。在每年一次的结肠镜检查监测计划中，对99例患者的危险因素进行了分析，以检测粘膜异型增生。所有患者均患有全结肠炎至少8年。出现症状时的平均年龄为23.2岁，入组时的平均病程为17年。平均每例患者进行4.2次测试，到1985年，91%的患者完全随访。癌症风险表示为风险率或无癌症患者在给定时间段存活后发生癌症的年概率。从症状发作开始测量的全结肠炎患者中高度结肠炎或癌症的风险率在20年时为2.5%，25年时为4%，30年时为7%，35年时为13%，40年时为20%。性别不是癌症的重要预测因素，但症状发作时年龄较大是乳腺癌和癌症的预测因素。根据这些数据，可以根据症状发作时的年龄和疾病持续时间估计全结肠炎患者发生高度异型增生或癌症的年危险率。
The risk of colon cancer in patients with ulcerative colitis is reduced to the duration and extent of disease. Prior reports have suggested that patients with onset of disease in childhood have a high risk of cancer. The risk factors were analyzed in 99 patients in a surveillance program of annual colonoscopy to detect mucosal dysplasia. All patients had pancolitis for at least eight years. The mean age at symptom onset was 23.2 years and the mean duration of disease at entry was 17 years. An average of 4.2 tests/patient were performed, and 91% were completely followed through 1985. Cancer risk was expressed as the hazard rate or the annual probability that a patient free of cancer would develop cancer after survival of a given time period. The hazard rate for high-grade displasia or cancer in patients with pancolitis measured from symptom onset was 2.5% at 20 years, 4% at 25 years, 7% at 30 years, 13% at 35 years, and 20% at 40 years. Sex was not a significant predictor of cancer, but older age at symptom onset was a predictor of displasia and cancer. From these data, the annual hazard rate of developing high-grade dysplasia or cancer can be estimated in patients with pancolitis based on an individual''s age at symptom onset and duration of disease.