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患有溃疡性结肠炎(Ulcerative Colitis,UC)和克隆氏病的患者发展成为结肠、直肠癌的危险性大大增加。病变范围越大、病程越长、并发原发性硬化性胆管炎和有肠癌家族史的病人是UC病人中恶变危险性最高的。发病年龄轻、炎症反应重也是高危因素之一。减轻结肠炎患者癌变危险的方法包括不典型监测和预防性结肠切除术,但是大部分UC和克隆氏病人不能接受手术预防。尽管很多学者推荐,但是监测并没有减少肠癌的发病率和死亡率。做监测的病理医生很难达成统一意见。病人失访、发现不典型增生后没有及时建议手术治疗等很多因素使监测很难有效发挥作用。为了弥补监测的局限性,现正在评估药物预防和内镜、分子技术能够替代传统监测,或增加传统监测的有效性。
In patients with ulcerative colitis (UC) and Crohn’s disease, the risk of developing colon, rectal cancer is greatly increased. The greater the lesion, the longer the course of the disease, complicated by primary sclerosing cholangitis and family history of colorectal cancer patients with UC is the highest risk of malignant transformation. Age of onset of light, severe inflammatory response is one of the risk factors. Methods to reduce the risk of cancer in colitis patients include atypical surveillance and prophylactic colectomy, but most UC and Crohn’s patients can not be treated for surgery. Although recommended by many scholars, surveillance did not reduce the incidence and mortality of colorectal cancer. Pathologists doing surveillance find it difficult to reach a consensus. The patient lost to follow-up and found that many factors, such as surgical treatment, were not suggested in time after atypical hyperplasia, making it difficult to monitor effectively. To remedy the limitations of surveillance, drug prevention and endoscopy are being evaluated and molecular techniques can replace traditional surveillance or increase the effectiveness of traditional surveillance.