溃疡性结肠炎相关腺瘤和结直肠癌回顾性临床病例分析

背景:研究表明溃疡性结肠炎(UC)患者发生结直肠癌的风险明显增加。目的:总结UC相关腺瘤和UC相关结直肠癌(UcCRC)的发病概况和临床病理特点。方法:选取2000年1月～2012年3月南京军区南京总医院住院确诊的UC患者603例,对其中UC相关腺瘤和UcCRC患者的性别、年龄、病程、临床症状、病理表现等临床资料进行回顾性分析经。结果:603例UC患者中,UC相关腺瘤28例,发病率为4.6%(28/603);UcCRC 4例,发病率为0.7%(4/603)。UC相关腺瘤患者的UC中位病程为3年,UcCRC患者的UC中位病程为29年。UC相关腺瘤好发部位依次为直肠/乙状结肠(16处)、降结肠(7处)、横结肠(6处)、升结肠以及回盲部(4处),UcCRC发病部位分别为升结肠(1例)、降结肠(2例)、乙状结肠(1例)。UC相关腺瘤和UcCRC的临床症状与一般UC相似。结论:UC相关腺瘤和UcCRC的发病率随UC病程的延长而增加。长期病程的UC患者应定期行结肠镜检查,对预防和早期检出结直肠癌具有积极意义。

Ulcerative Colitis-associated Adenoma and Colorectal Cancer: A Retrospective Case Analysis

Studies indicated that the risk of colorectal cancer increased in patients with ulcerative colitis （UC）. Aims： To investigate the incidence and clinicopathology of UC-associated adenoma and UC-associated colorectal cancer （UcCRC）. Methods： A total of 603 patients with UC admitted from Jan. 2000 to Mar. 2012 at Nanjing General Hospital of Nanjing Military Command were enrolled. Retrospective analysis of clinical data including gender, age, course of disease, clinical symptoms and pathology was performed in patients with UC-associated adenoma and UcCRC. Results： Of the 603 UC patients, 28 （4.6%） had UC-associated adenoma, 4 （0.7%） had UcCRC. The median courses of UC in patients with UC- associated adenoma and UcCRC were 3 and 29 years, respectively. The predilection sites of UC-associated adenoma were rectum/sigmoid colon （16 sites）, descending colon （7 sites）, transverse colon （6 sites ）, ascending colon and ileocecal junction （4 sites）, and UcCRC located at ascending colon （1 case）, descending colon （2 cases） and sigmoid colon （1 case）. The clinical symptoms of UC-associated adenoma and UcCRC were similar to those of UC. Conclusions： The incidences of UC-associated adenoma and UcCRC increase with the prolongation of disease course of UC. Patients with prolonged course of UC should undertake colonoscopv rezularlv for the ~revention and early detection of colorectal cancer.