Detection of Dysplasia or Cancer in 3.5% of Patients With Inflammatory Bowel Disease and Colonic Strictures

医学 发育不良 炎症性肠病 溃疡性结肠炎 癌症 结直肠癌 内科学 胃肠病学 克罗恩病 外科 疾病
作者
Mathurin Fuméry,Guillaume Pineton de Chambrun,Carmen Stefănescu,Anthony Buisson,Aude Bressenot,Laurent Beaugerie,Aurélien Amiot,Romain Altwegg,Guillaume Savoye,Véred Abitbol,Guillaume Bouguen,M. Simon,Jean-Pierre Duffas,Xavier Hébuterne,Stéphane Nancey,Xavier Roblin,Emmanuelle Leteurtre,Gilles Bommelaer,Jérémie H. Lefèvre,Francesco Brunetti,F. Guillon,Yoram Bouhnik,Laurent Peyrin‐Biroulet
出处
期刊:Clinical Gastroenterology and Hepatology [Elsevier BV]
卷期号:13 (10): 1770-1775 被引量:80
标识
DOI:10.1016/j.cgh.2015.04.185
摘要

Colonic strictures complicate inflammatory bowel disease (IBD) and often lead to surgical resection to prevent dysplasia or cancer. We assessed the frequency of dysplasia and cancer among IBD patients undergoing resection of a colorectal stricture.We analyzed data from the Groupe d'études et thérapeutiques des affections inflammatoires du tube digestif study. This was a nationwide retrospective study of 12,013 patients with IBD in France who underwent surgery for strictures at 16 centers from August 1992 through January 2014 (293 patients for a colonic stricture, 248 patients with Crohn's disease, 51% male, median age at stricture diagnosis of 38 years). Participants had no preoperative evidence of dysplasia or cancer. We collected clinical, endoscopic, surgical, and pathology data and information on outcomes.When patients were diagnosed with strictures, they had IBD for a median time of 8 years (3-14). The strictures were a median length of 6 cm (4-10) and caused symptoms in 70% of patients. Of patients with Crohn's disease, 3 (1%) were found to have low-grade dysplasia, 1 (0.4%) was found to have high-grade dysplasia, and 2 (0.8%) were found to have cancer. Of patients with ulcerative colitis, 1 (2%) had low-grade dysplasia, 1 (2%) had high-grade dysplasia, and 2 (5%) had cancer. All patients with dysplasia or cancer received curative surgery, except 1 who died of colorectal cancer during the follow-up period. No active disease at time of surgery was the only factor associated with dysplasia or cancer at the stricture site (odds ratio, 4.86; 95% confidence interval, 1.11-21.27; P = .036).In a retrospective study of patients with IBD undergoing surgery for colonic strictures, 3.5% were found to have dysplasia or cancer. These findings can be used to guide management of patients with IBD and colonic strictures.
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