肠上皮细胞在炎症性肠病患者中的异型增生、癌变及其临床检测  

Intestinal epithelial dysplasia and cancerization in inflammatory bowel disease

作　　者：黄志刚[1] 刘占举[1] 

机构地区：[1]同济大学附属第十人民医院胃肠内科,上海市200072

出　　处：《世界华人消化杂志》2010年第29期3096-3100,共5页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No.30770988;No.30971358~~

摘　　要：炎症性肠病(inflammatory bowel disease,IBD)患者并发肠上皮细胞异型增生和结直肠癌的危险性增高.溃疡性结肠炎发生结直肠癌危险与克罗恩病相当.IBD患者癌变的易患因素包括病程、病情、炎症严重程度及是否合并原发硬化性胆管炎等.IBD癌变的模式为炎症-异型增生-癌.结肠镜监测筛查并随机活检仍是最主要的检测早期异型增生的手段.一旦发现异型增生,多数要考虑全结肠切除术.病程超过8-10年的IBD患者应该接受结肠镜筛查监测.新的内镜技术和分子学方法可使异型增生监测更为方便并加深对IBD癌变的理解.Patients with inflammatory bowel disease （IBD） have an increased risk of developing intestinal epithelial dysplasia and colorectal cancer （CRC）. The risk of CRC in patients with ulcerative colitis is equivalent to that in patients with Crohn＇ s disease. Risk factors for the carcinogenesis of CRC among IBD patients include the extent and duration of disease, increased severity of inflammation, and coexisting primary sclerosing cholangitis （PSC）. The neoplastic transformation in IBD is thought to occur in the inflammation-dysplasia-carcinoma sequence. Colonoscopic surveillance with random biopsies remains the major way to detect early dysplasia. When dysplasia is found, proctocolectomy should be considered for these patients. After 8-10 years of the disease, patients should begin to undergo surveillance colonoscopy to detect dysplasia and CRC. New endoscopic and molecular screening approaches may further facilitate dysplasia surveillance and provide deep understanding of IBD-associated neoplastic transformation.

关 键 词：炎症性肠病 异型增生 癌变 内镜检测 

分 类 号：R574[医药卫生—消化系统]