Am J Gastroenterol:炎症性肠病(IBD)与胆管癌风险增加有关

2016-03-29 Seven L MedSci原创

近期在线发表在The American Journal of Gastroenterology的研究称,长期患有炎症性肠病(IBS)和原发性硬化性胆管炎(PSC),会增加胆管癌风险增加。该回顾性研究纳入了2005年1月-2013年5月就诊于Mayo诊所的399名PSC-IBD患者。其中有137名患者接受了结肠切除术。研究数据显示,研究期间有123名患者发展为胆管癌。单因素Cox比例风险模型分析显示

近期在线发表在The American Journal of Gastroenterology的研究称,长期患有炎症性肠病(Inflammatory Bowel Disease,IBD)和原发性硬化性胆管炎(PSC),会增加胆管癌风险增加。



该回顾性研究纳入了2005年1月-2013年5月就诊于Mayo诊所的399名PSC-IBD患者。其中有137名患者接受了结肠切除术。

研究数据显示,研究期间有123名患者发展为胆管癌。单因素Cox比例风险模型分析显示,校正年龄后,结肠切除术(HR=1.53;95% CI,1.05-2.22)和炎症性肠病持续时间(HR=1.37;95% CI,1.15-1.63)会增加胆管癌风险。随着年龄的增加,行结肠切除术的患者其胆管癌绝对风险高于没有行结肠切除术的患者(39% vs 27%)。

此外,结肠肿瘤(HR=1.52;95% CI,0.97-2.37)和因结肠肿瘤行结肠切除术(HR=1.62;95% CI,1.01-2.61)接近统计学意义的边缘。与其他难治性疾病相比,有结肠切除术史的患者中,有结肠肿瘤手术指征的患者,其胆管癌风险更高(HR=2.91;95% CI,1.24-6.84)。

多变量分析显示,IBD持续时间仍与胆管癌相关(HR=1.33;95% CI,1.11-1.60)。结肠切除术后,IBD持续时间对胆管癌风险的影响没有改变。

研究人员总结道:“PSC-IBD患者中持续存在的IBD是胆管癌风险的独立预测因素,并且在结肠切除术后,这种风险仍然存在。对胆管癌患者进行早发现、早诊断、早治疗具有重要意义。”

原始出处:

Gulamhusein AF, et al. Duration of Inflammatory Bowel Disease Is Associated With Increased Risk of Cholangiocarcinoma in Patients With Primary Sclerosing Cholangitis and IBD.Am J Gastroenterol. 2016;doi:10.1038/ajg.2016.55.

Prolonged IBD increases risk for cholangiocarcinoma in patients with primary sclerosing cholangitis.
MedicalXpress.March 24, 2016

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    2016-11-23 sjq027
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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=74435, encodeId=16e2e443522, content=肿瘤可能与微炎症存在关联, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Tue Mar 29 13:17:00 CST 2016, time=2016-03-29, status=1, ipAttribution=)]
    2016-09-16 1e10c84am36(暂无匿称)

    不错哦,会学到很多

    0

  4. 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createdName=ms24272190615788285182, createdTime=Wed Jun 01 05:35:00 CST 2016, time=2016-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128610, encodeId=122e1286100f, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:53:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2063963, encodeId=442c2063963ae, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Wed Sep 07 08:35:00 CST 2016, time=2016-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071627, encodeId=e01d20e1627b2, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sat Feb 11 02:35:00 CST 2017, time=2017-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263421, encodeId=e0e4126342191, content=<a href='/topic/show?id=75bc930217' target=_blank style='color:#2F92EE;'>#IBD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9302, encryptionId=75bc930217, topicName=IBD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc0372, createdName=bnurmamat, createdTime=Thu Mar 31 03:35:00 CST 2016, time=2016-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547014, encodeId=25c1154e014c9, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Thu Mar 31 03:35:00 CST 2016, time=2016-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628265, encodeId=c27e162826575, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Thu Mar 31 03:35:00 CST 2016, time=2016-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=74443, encodeId=f232e4443e0, content=PSC-IBD患者中持续存在的IBD是胆管癌风险的独立预测因素,并且在结肠切除术后,这种风险仍然存在。, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160227/IMG56D1078DD4F344111.jpg, createdBy=80b71692457, createdName=壹生, createdTime=Tue Mar 29 15:53:00 CST 2016, time=2016-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=74435, encodeId=16e2e443522, content=肿瘤可能与微炎症存在关联, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Tue Mar 29 13:17:00 CST 2016, time=2016-03-29, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2061519, encodeId=7a9f20615196c, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Wed Nov 23 00:35:00 CST 2016, time=2016-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710858, encodeId=25ec1e108588f, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Jun 01 05:35:00 CST 2016, time=2016-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=128610, encodeId=122e1286100f, content=不错哦,会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:53:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2063963, encodeId=442c2063963ae, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Wed Sep 07 08:35:00 CST 2016, time=2016-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071627, encodeId=e01d20e1627b2, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Sat Feb 11 02:35:00 CST 2017, time=2017-02-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1263421, encodeId=e0e4126342191, content=<a href='/topic/show?id=75bc930217' target=_blank style='color:#2F92EE;'>#IBD#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9302, encryptionId=75bc930217, topicName=IBD)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc0372, createdName=bnurmamat, createdTime=Thu Mar 31 03:35:00 CST 2016, time=2016-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547014, encodeId=25c1154e014c9, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Thu Mar 31 03:35:00 CST 2016, time=2016-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1628265, encodeId=c27e162826575, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Thu Mar 31 03:35:00 CST 2016, time=2016-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=74443, encodeId=f232e4443e0, content=PSC-IBD患者中持续存在的IBD是胆管癌风险的独立预测因素,并且在结肠切除术后,这种风险仍然存在。, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160227/IMG56D1078DD4F344111.jpg, createdBy=80b71692457, createdName=壹生, createdTime=Tue Mar 29 15:53:00 CST 2016, time=2016-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=74435, encodeId=16e2e443522, content=肿瘤可能与微炎症存在关联, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Tue Mar 29 13:17:00 CST 2016, time=2016-03-29, status=1, ipAttribution=)]
    2017-02-11 许安
  6. [GetPortalCommentsPageByObjectIdResponse(id=2061519, encodeId=7a9f20615196c, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d58a435, createdName=sjq027, createdTime=Wed Nov 23 00:35:00 CST 2016, time=2016-11-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1710858, encodeId=25ec1e108588f, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, 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encodeId=c27e162826575, content=<a href='/topic/show?id=9a4e83503e4' target=_blank style='color:#2F92EE;'>#胆管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83503, encryptionId=9a4e83503e4, topicName=胆管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Thu Mar 31 03:35:00 CST 2016, time=2016-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=74443, encodeId=f232e4443e0, content=PSC-IBD患者中持续存在的IBD是胆管癌风险的独立预测因素,并且在结肠切除术后,这种风险仍然存在。, beContent=null, objectType=article, channel=null, level=null, likeNumber=183, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160227/IMG56D1078DD4F344111.jpg, createdBy=80b71692457, createdName=壹生, createdTime=Tue Mar 29 15:53:00 CST 2016, time=2016-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=74435, encodeId=16e2e443522, content=肿瘤可能与微炎症存在关联, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Tue Mar 29 13:17:00 CST 2016, time=2016-03-29, status=1, ipAttribution=)]
    2016-03-31 bnurmamat
  7. 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  9. 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    2016-03-29 壹生

    PSC-IBD患者中持续存在的IBD是胆管癌风险的独立预测因素,并且在结肠切除术后,这种风险仍然存在。

    0

  10. 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    2016-03-29 lovetcm

    肿瘤可能与微炎症存在关联

    0

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根据Lancaster大学科学家开展的一项研究发现:炎性肠病(IBD)的发展会受到肠道中一种能导致炎症的蛋白质的影响。 在英国,每百人中有一人在其一生中将罹患IBD,包括克罗恩病和溃疡性结肠炎。肠衬里被修复的速度取决于其与肠道中细菌的相互作用。Lancaster大学的Rachael Rigby医生说:在发达国家IBD发病增加的潜在原因包括人们肠道微生物的改变。肠道微生物的改变影响

Am J Gastroenterol:IBD患者,需注意维生素D水平

研究者进行了一项研究,探究维生素D水平和炎症性肠病(IBD)的关系。研究者对IBD患者进行了长达5年的随访,根据患者的维生素D水平将其分类。通过使用药物类型、医疗利用率、炎症相关生化标志物(CRP和ESR)、疼痛、临床疾病活动评分和健康相关生活质量评估患者IBD的临床状况。研究数据显示,纳入的965名IBD患者中,克罗恩病占61.9%,溃疡性结肠炎占38.1%,患者平均年龄44岁,其中女性占52.

Clin Gastroenterol Hepatol:睡眠质量影响溃疡性结肠炎发病风险

睡眠不足现象在人群中非常普遍,而且与许多健康问题息息相关。已有报道指出,过短或过长的睡眠可能增加大肠癌的发病风险。另外,睡眠质量问题在炎症性肠病(IBD)患者中也很常见,并且会增加疾病复发的风险。 IBD的发病机制至今难以解释清楚,目前认为和遗传基因、肠道微环境以及环境因素有关。睡眠与IBD发病是否有关系呢?来自麻省总医院的Ananthakrishnan教授等进行了一项前瞻性队列研究,成果发表在