溃疡性结肠炎相关性结直肠癌患者的临床特点分析

Analysis on clinical features of patients with ulcerative colitis associated colorectal cancer

目的:分析溃疡性结肠炎(UC)结直肠癌变患者的临床特点。方法:回顾性分析1998年1月1日至2018年1月1日在北京协和医院住院的UC患者869例,通过病例资料、电话随访获取患者的临床特点及结直肠癌的发生情况,利用SAS 9.4软件分别对UC相关结直肠癌和UC不合并结直肠癌患者的临床特点、药物治疗、并发症及肠外表现情况进行单因素对比分析,后将单因素分析结果中P<0.05的指标纳入logistic回归多因素分析。结果:869例UC患者共随访7548人年,其中有16例UC患者发生结直肠癌,结直肠癌的发生率为1.84%。与UC不合并结直肠癌患者相比,UC合并结直肠癌患者病程较长(OR=1.087,95%CI:1.046~1.129)、5-氨基水杨酸(5-ASA)应用比例较低(OR=0.218,95%CI:0.052~0.915)、肠梗阻的发生率较高(OR=16.533,95%CI:3.824~71.478)。结论:病程长是UC合并结直肠癌的危险因素,5-ASA是UC合并结直肠癌的保护因素。对于UC合并肠梗阻的患者,需警惕结直肠癌的可能。

Objective To analyze the clinical features of ulcerative colitis associated colorectal cancer(UC-CRC).Methods A total of 869 inpatients with Ulcerative Colitis(UC)in Peking Union Medical Hospital from January 1998 to January 2018 were continuously enrolled.Clinical data and the outcome of colorectal cancer(CRC)were collected via medical records and telephone follow-up.Chi-square test and logistic regression model were used to analyze the data.Results There were 16 patients in 869 UC inpatients who were diagnosed with CRC during a period of 7548 person years and the incidence rate of UC-CRC was 1.84%.Compared to UC inpatients without CRC,a longer course of disease(OR=1.087,95%CI:1.046-1.129),a lower usage rate of 5-Aminosalicylic Acid(5-ASA)(OR=0.218,95%CI:0.052-0.915)and a higher incidence rate of intestinal stenosis(OR=16.533,95%CI:3.824-71.478)were found in UC inpatients with CRC.Conclusions A long disease course is a risk factor for UC patients developing CRC,while 5-ASA therapy can reduce the risk of suffering from CRC.For UC patients with intestinal stenosis,CRC should be warned for occurring.