中国全科医学Issue(6)：652-657,6.DOI:10.3969/j.issn.1007-9572.2016.06.007
炎症性肠病结肠隆起型异型增生影响因素的回顾性研究
Retrospective Analysis of Relevant Influencing Factors for the Occurrence of Uplift Type Dysplasia in the Colons of Patients With Inflammatory Bowel Disease
田雨 1李俊霞 1田原 1刘冠伊 1王化虹 1刘新光1
作者信息
- 1. 100034 北京市，北京大学第一医院消化内科
- 折叠
摘要
Abstract
Background As the prevalence of inflammatory bowel disease( IBD) in China is increasing,the morbidity of IBD associated colorectal cancer and precancerous lesions are worth noticing. Objective To investigate relevant influencing factors for the occurrence of IBD colon uplift type dysplasia. Methods A total of 393 IBD patients who were followed up by endoscope in Peking University First Hospital from January 2007 to January 2014 were enrolled in the study. Clinical data and pathological results of the patients were collected. With uplift type dysplasia as outcome event and disease duration as time variable,the influencing factors for the occurrence of IBD colon uplift type dysplasia were analyzed and screened by Cox proportional hazards regression. Results A total of 13 cases had colon uplift type dysplasia among the 393 IBD cases. Among the 13 cases,12 cases were ulcerative colitis and 1 case was Crohn′s disease;10 cases had adenoma - like lesion or mass(ALM) and 3 cases had dysplasia associated lesion or mass(DALM). The result of Cox proportional hazards regression model showed that regression correlation existed between colon uplift type dysplasia and IBD family history,disease activity degree and disease relapse(P < 0. 05);regression correlation did not exist between colon uplift type dysplasia and gender,onset age,family history of colon cancer,smoking,scope of lesions and receiving maintenance treatment of 5 - aminosalicylic acid(5-ASA)/ Salazosulfapyridine(SASP)for at least two years(P > 0. 05). Log - rank test result showed that cumulative survival rate of patients who had no IBD family history and had moderate activity and accidental symptoms was higher than that of patients who had IBD family history,severe activities and frequent symptoms/ persistent activity( χ2 = 4. 631,7. 382,13. 438;P = 0. 031, 0. 007, < 0. 001). Among 10 cases of ALM,9 cases were given tumor resection by endoscope and 1 case with multiple ALM was given total colectomy. Among 3 cases of DALM,1 case was given total colectomy and 2 cases were not given operative treatment because of serious disease or poor general physical condition. Conclusion The incidence of IBD colon uplift type dysplasia increases with prolonged disease duration. High risk factors include IBD family history,disease activity degree and disease relapse.关键词
肠炎/结肠炎,溃疡性/克罗恩病/增生/影响因素分析Key words
Enteritis/Colitis,ulcerative/Crohn disease/Hyperplasia/Root cause analysis分类
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田雨,李俊霞,田原,刘冠伊,王化虹,刘新光..炎症性肠病结肠隆起型异型增生影响因素的回顾性研究[J].中国全科医学,2016,(6):652-657,6.
