Risk of Colorectal Cancer in Inflammatory Bowel Disease: Prevention and Monitoring Strategies According With Risk Factors

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL Clinical Management Issues Pub Date : 2021-02-05 DOI:10.7175/CMI.V15I1.1464

E. Giuffrida, M. Mangia, A. Lavagna, E. Morello, M. Cosimato, R. Rocca, M. Daperno

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引用次数: 1

Abstract

Colorectal cancer (CRC) is slightly increased in inflammatory bowel disease (IBD) patients, with roughly a 2.5-fold increase compared to the general population. Clinical features associated to CRC risks are extent and severity of colonic involvement, disease duration, concomitant primary sclerosing cholangitis (PSC) and/or familial history of CRC in first-degree relatives. Colonic Crohn’s disease (CD) and ulcerative colitis (UC) share similar risks when similar colonic extent is affected. Risk stratification affects outcomes and surveillance programs. Newer endoscopic techniques substantially ameliorated diagnostic performance of endoscopy, and nowadays the standard for CRC surveillance in IBD patients is high-definition endoscopy, with dye-spray or virtual colonoscopy, oriented at targeted (+ random) colonic biopsies. Visible dysplastic lesions should be considered for endoscopic resection, while invisible dysplasia is still a mandatory proctocolectomy indication. Newer endoscopic interventional techniques (endoscopic mucosa resection, EMR, and endoscopic submucosal dissection, ESD) are appropriate therapeutic techniques to be delivered, but long-term risks of cancer should be balanced towards proctocolectomy.

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炎症性肠病的结直肠癌风险:根据危险因素的预防和监测策略

结直肠癌(CRC)在炎症性肠病(IBD)患者中略有增加，与一般人群相比约增加2.5倍。与结直肠癌风险相关的临床特征是结肠累及程度和严重程度、疾病持续时间、伴有原发性硬化性胆管炎(PSC)和/或一级亲属有结直肠癌家族史。结肠克罗恩病(CD)和溃疡性结肠炎(UC)在结肠受影响程度相似时风险相似。风险分层影响结果和监测方案。较新的内窥镜技术大大改善了内窥镜的诊断性能，目前IBD患者CRC监测的标准是高清晰度内窥镜，采用染料喷雾或虚拟结肠镜，定向(+随机)结肠活检。可见的发育不良病变应考虑内镜切除，而不可见的发育不良仍是强制直结肠切除术的指征。较新的内镜介入技术(内镜粘膜切除，EMR，内镜粘膜下剥离，ESD)是合适的治疗技术，但长期癌症风险应平衡直肠切除术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Management Issues MEDICINE, GENERAL & INTERNAL-

自引率

0.00%

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审稿时长

13 weeks

期刊介绍： Clinical Management Issues is an open access, peer-reviewed journal published by SEEd Medical Publishers (online ISSN = 2283-3137). The aim of the published case reports is to expand medical knowledge, allowing a better explanation of the practical application of a clinical guideline, or including an up-to-date review of medical knowledge in that field, or helping doctors to make better decisions in a “grey area”, or explaining how to manage a disease with an integrated approach between different specialists involved. Clinical Management Issues also publishes unusual case reports (i.e. unusual side effects or adverse interactions involving medications, unexpected or unusual presentations of a disease, etc.), articles on clinical management of a disease, case series, editorials, and brief reports. Acceptance rate of submitted articles is about 90%. Content is subject to peer-review and is editorially independent. This journal provides immediate open access to all of its articles (both HTML and PDF versions). Authors are asked to state any professional and financial situations that might be perceived as causing a conflict of interest with respect to integrity of content. The Declaration of Financial Competing Interests, that should be filled, signed and sent to the Publisher, is downloadable here.