Inflammatory bowel disease-and Barrett’s esophagus-associated neoplasia:the old,the new,and the persistent struggles  

炎症性肠病相关及Barrett食管相关的肿瘤:过去、现在、一直在努力

作　　者：Dipti M.Karamchandani Qin Zhang Xiao-Yan Liao Jing-Hong Xu Xiu-Li Liu 

机构地区：[1]Department of Pathology,Penn State HealthMilton S.Hershey Medical Center,Hershey,PA,USA [2]Department of Pathology,The Third Central Hospital of Tianjin,Tianjin,China [3]Department of Pathology and Laboratory Medicine,University of Rochester Medical Center,Rochester,NY,USA [4]Department of Pathology,The Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou,Zhejiang,China [5]Department of Pathology,Immunology,and Laboratory Medicine,University of Florida,Gainesville,FL,USA

出　　处：《Gastroenterology Report》2019年第6期379-395,I0001,共18页胃肠病学报道（英文）

摘　　要：Early diagnosis of and adequate therapy for premalignant lesions in patients with inflammatory bowel disease(IBD)and Barrett’s esophagus(BE)has been shown to decrease mortality.Endoscopic examination with histologic evaluation of random and targeted biopsies remains the gold standard for early detection and adequate treatment of neoplasia in both these diseases.Although eventual patient management(including surveillance and treatment)depends upon a precise histologic assessment of the initial biopsy,accurately diagnosing and grading IBD-and BE-associated dysplasia is still considered challenging by many general as well as subspecialized pathologists.Additionally,there are continuing updates in the literature regarding the diagnosis,surveillance,and treatment of these disease entities.This comprehensive review discusses the cancer risk,detailed histopathological features,diagnostic challenges,and updates as well as the latest surveillance and treatment recommendations in IBD-and BE-associated dysplasia.对炎症性肠病(IBD)和Barrett食管(BE)患者癌前病变的早期诊断和充分治疗可以降低死亡率。内镜检查及活检仍然是早期诊断和充分治疗IBD/BE相关肿瘤的金标准。尽管最终的处理(包括随访和治疗)取决于对初始活检标本的精准组织学评估,对IBD/BE相关肿瘤的准确诊断和分级却仍然是病理医生的一大挑战。此外,对这些患者的诊断、随访和治疗,相关文献也处于持续更新中。本文探讨了IBD/BE相关肿瘤的癌变风险、详细的组织病理学特征及诊断难点,并对其随访和治疗作出了最新推荐。

关 键 词：Barrett’s esophagus inflammatory bowel disease DYSPLASIA SURVEILLANCE 

分 类 号：R735.1[医药卫生—肿瘤]