Primary sclerosing cholangitis and the risk of colon neoplasia in patients with Crohn’s colitis

作     者：Udayakumar Navaneethan Tarun Rai Preethi GK Venkatesh Ravi P Kiran 

作者机构：Department of GastroenterologyDigestive disease InstituteThe Cleveland ClinicClevelandOHUSA Department of Colorectal SurgeryDigestive disease InstituteThe Cleveland ClinicClevelandOHUSA 

出 版 物：《Gastroenterology Report》 (胃肠病学报道（英文）)

年 卷 期：2016年第4卷第3期

页      面：226-231,I0002页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：The study is supported by a research grant from the inflammatory bowel disease working group(U.N.) 

主　　题：Crohn’s colitis primary sclerosing cholangitis colon neoplasia 

摘      要：Background and aim:Crohn’s colitis(CC)is associated with primary sclerosing cholangitis(PSC).However the risk of colon cancer or dysplasia in CC and PSC is *** aim was to study the risk of colon neoplasia in CC in patients with and without ***:This is a nested,case-control cohort study of all patients diagnosed with concurrent CC and PSC,seen at the Cleveland Clinic between 1985 and ***-three patients with both CC and PSC were compared with a random sample of 159 CC controls without PSC during the same ***:Seven(16.3%)of 43 CC patients with PSC developed colon cancer or dysplasia,compared with 22(13.8%)of 159 controls(P=0.98).Of seven colon neoplasia cases in the PSC group,100%occurred proximal to the splenic flexure,compared with 50%(11/22)cases of colon neoplasia in controls occurring in the proximal colon(P=0.001).Based on Cox regression analysis,male gender independently increased the risk of neoplasia[hazard ratio(HR)=2.68;95%confidence interval(CI)1.30-5.54;P=0.008],as did age at CC diagnosis(HR=1.29;95%CI 1.14-1.47;P0.001),while the use of azathioprine/6-mercaptopurine was protective(HR=0.30;95%CI 0.13-0.70;P=0.005).The presence of PSC did not increase the risk for colon neoplasia(HR=0.45;95%CI 0.18-1.13;P=0.09).Conclusions:CC patients with PSC appear not to be at increased risk of developing colon *** patients in our cohort with colon neoplasia and concurrent PSC,the neoplasia occurred in the proximal colon in all cases.