炎性肠病相关的结直肠癌的研究进展

Research Progress of Colorectal Cancer related to Inflammatory Bowel Disease

人们从1925年开始认识到炎性肠病(IBD)与结直肠癌(CRC)的关系,结直肠癌占炎性肠病死亡病例的10%~15%。炎性肠病相关性结直肠癌(IBD-CRC)主要累及年轻患者。IBD-CRC与散发性结直肠癌预后近似,5年生存率约50%。应对炎性肠病发生结直肠癌风险的核心是明确高危人群并进行有效的监控。通常认为先天基因因素和后天获得因素可提高IBD-CRC发生风险。炎症和肿瘤之间的关系目前已被明确认识,但分子生物学、免疫病理学和IBD-CRC基因学仍是不断深入探索的学科。本文检索有关IBD-CRC的相关文献主要针对IBD-CRC的分子生物学、量化风险、风险因素(如结肠炎的病程周期、范围、炎症程度、合并PSC等)、治疗策略、疾病监测等,以期为IBD-CRC的临床研究提供参考。

The association between inflammatory bowel disease（IBD） and colorectal cancer（CRC） has been recognised since 1925,and CRC accounts for 10%-15%of deaths in IBD.IBD-CRC mainly involved in young patients.The prognosis of sporadic CRC is similar to IBD-CRC,with a 5-year survival of approximately 50%.Identifying at risk patients and implementing appropriate surveillance for these patients are central to managing the CRC risk in IBD.The increased risk of IBD-CRC is thought to be due to genetic and acquired factors.The link between inflammation and cancer is well recognised,but the molecular biology,immune pathobiology and genetics of IBD-CRC are areas of much ongoing research.This review examined the literature relating to IBD-CRC,focusing on the molecular biology,quantitative risk,risk factor（including the periodicity,range,degree of inflammation,and combined PSC of colitis）,treatment strategies,disease monitoring,in order to provide reference for clinical research on IBD-CRC.