炎症性肠病合并神经内分泌肿瘤的临床特征分析  

Clinical characteristics of inflammatory bowel disease complicating neuroendocrine neoplasms

作　　者：胡平[1] 柏建安 田野 刘敏[1] 汤琪云[1] Hu Ping;Bai Jian′an;Tian Ye;Liu Min;Tang Qiyun(Department of Geriatric Gastroenterology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院老年消化科,210029

出　　处：《中华消化内镜杂志》2021年第12期1021-1025,共5页Chinese Journal of Digestive Endoscopy

基　　金：江苏省"333"工程项目(BRA2017535)。

摘　　要：报道1例炎症性肠病(inflammatory bowel disease,IBD)合并神经内分泌肿瘤(neuroendocrine neoplasms,NENs)病例,结合文献报道的69例病例,总结分析IBD合并NENs的临床特征,探索两者之间的关系。69例IBD合并NENs患者中包括32例克罗恩病(Crohn disease,CD)及37例溃疡性结肠炎(ulcerative colitis,UC),男女发病率相当(P=0.151)。NENs多形成于IBD之后。CD患者发生NENs的中位病程为4.5年,小于UC患者的17年(P=0.002)。33例患者为术后或随访时发现NENs,有症状者中11例表现为肠梗阻。NENs好发部位与IBD相似,CD患者好发于回肠和阑尾(27例),而UC患者好发于结直肠(31例)(P<0.001)。CD患者中神经内分泌瘤更常见(26例),神经内分泌癌则在UC患者中更普遍(22例)(P<0.001)。IBD可合并或并发NENs,临床表现无特异性,病因尚不明确,有待进一步探索。A case of inflammatory bowel disease(IBD)complicating neuroendocrine neoplasms(NENs)was reported and 69 cases in references were reviewed to analyze the clinical features of IBD complicating NENs and to explore the connection between IBD and NENs.Thirty-two cases of Crohn disease(CD)and 37 cases of ulcerative colitis(UC)were included in the study.The occurrence rate showed no significant difference between males and females(P=0.151).NENs mostly occurred after the diagnosis of IBD.The median interval duration of NENs after CD was 4.5 years,which was significantly shorter than that of UC(17 years,P=0.002).Thirty-three cases discovered NENs occasionally with no special indications.Among those symptomatic patients,11 of them suffered from intestinal obstruction.The location of NENs was similar to IBD,that was,ileum and appendix in CD(27 cases)while colon and rectal in UC(31 cases,P<0.001).Neuroendocrine tumors were more common in CD(26 cases)while neuroendocrine carcinomas were more common in UC(22 cases,P<0.001).There is possibility that IBD complicate with NENs with no specific clinical features.The etiology of this phenomenon is still not clear,which needs further exploration.

关 键 词：炎性肠疾病 神经内分泌肿瘤 肠道菌群 免疫调节 

分 类 号：R574[医药卫生—消化系统] R739.4[医药卫生—内科学]