溃疡性结肠炎相关结直肠癌风险因素与预防进展

Advances on Risk Factors and Prevention of Ulcerative Colitis-Associated Colorectal Cancer

结直肠癌(CRC)是溃疡性结肠炎(UC)严重并发症之一,是UC患者死亡的重要原因。UC相关结直肠癌(UC-CRC)风险因素包括诊断时年龄、病程、炎症的程度及范围、CRC家族史、原发性硬化性胆管炎的合并,及吸烟、假性息肉、结肠持续炎症、结肠狭窄等。更多学者认为UC的癌变与肠黏膜反复炎症-修复密切相关,尤其是炎症的氧化应激、基因突变可能起到重要作用。预防上推荐结肠镜监测以减少CRC风险和UC的死亡率,新技术如放大内镜、色素内镜、共聚焦显微内镜均可能提高靶向活检效率。抗炎治疗是化学预防UC-CRC的主要方向,生物治疗、中医中药等对UC-CRC预防有广泛的应用前景。

One of the most serious complications of ulcerative colitis（UC） is the development of colorectal cancer （CRC）, is the important cause of death in patients with UC. Risk factors for CRC with UC patients including yound age at diagnosis, longer duration, anatomical extent of colonic involvement, the degree of inflammation, fami- ly history of CRC, concurrent of primary sclerosing cholangitis, and smoking, pseudopolyps, persistent inflammation and stricture of colon, etc. More scholars think UC cancer is closely related to intestinal mucosa inflammation with repeatedly repair. Especially the oxidative stress of inflammation and gene mutation may play an important role. Colonoscopy sureillance is recommended to reduce the mortality risk of CRC and UC, new techniques such as amplification endoscopy, chromoendoscopy, confoeal endomicroscopy could improve the efficiency of targeted biop- sy. Anti-inflammatory therapy is the main way of UC-CRC for chemical prevention, biological treatment and tradi- tional Chinese medicine for UC-CRC prevention has carried out extensive application prospect.