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Risk of cancer,with special reference to extra-intestinal malignancies,in patients with inflammatory bowel disease

World Journal of Gastroenterology 2013年第48期19卷 9359-9365页

作者： Alicia Algaba Iván Guerra ngel Castao gema de la poza Víctor M Castellano Montserrat López Fernando Bermejo department of Gastroenterology Hospital Universitario de Fuenlabrada 28942 Madrid Spain department of Pathology Hospital Universitario de Fuenlabrada28942 Madrid Spain

AIM:To determine the incidence and characteristics of intestinal and extra-intestinal cancers among patients with inflammatory bowel disease in a Spanish hospital and to compare them with those of the local population.METHODS:This was a prospective,observational,7-year follow-up,cohort study.Cumulative incidence,incidence rates based on person-years of follow-up and relative risk were calculated for patients with inflammatory bowel disease and compared with the background population.The incidence of cancer was determined using a hospital-based data registry from Hospital Universitario de Fuenlabrada.demographic data and details about time from diagnosis of inflammatory bowel disease to occurrence of cancer,disease extent,inflammatory bowel disease treatment,cancer therapy and cancer evolution were also collected in the inflammatory bowel disease cohort.RESULTS:Eighteen of 590 patients with inflammatory bowel disease developed cancer[cumulative incidence=3%(95%CI:1.58-4.52)vs 2%(95%CI:1.99-2.11)in the background population;RR=1.5;95%CI:0.97-2.29].The cancer incidence among inflammatory bowel disease patients was 0.53%(95%CI:0.32-0.84)per patient-year of follow-up.Patients with inflammatory bowel disease had a significantly increased relative risk of urothelial carcinoma(RR=5.23,95%CI:1.95-13.87),appendiceal mucinous cystadenoma(RR=36.6,95%CI:7.92-138.4),neuroendocrine carcinoma(RR=13.1,95%CI:1.82-29.7)and rectal carcinoid(RR=8.94,95%CI:1.18-59.7).Colorectal cancer cases were not found.CONCLUSION:The overall risk of cancer did not significantly increase in our inflammatory bowel disease patients.However,there was an increased risk of urinary bladder cancer and,with less statistical power,an increased risk of appendiceal mucinous cystadenoma and of neuroendocrine tumors.Colorectal cancer risk was low in our series.

关键词： Extra-intestinal cancer Inflammatory bowel disease Cancer risk Background population Urothelial carcinoma Appendiceal mucinous cystadenoma Neuroendocrine carcinoma Rectal carcinoid

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Gastric inflammatory myofibroblastic tumor, a rare mesenchymalneoplasm: A case report

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World Journal of Gastrointestinal Surgery 2023年第11期15卷 2657-2662页

作者： Manuel Fernandez Rodriguez Pedro Joaquin Artuñedo Pe Alejandro Callejas Diaz Gala Silvestre Egea Cristián Grillo Marín Eva Iglesias Garcia Jose Luis Lucena de la poza department of General and Digestive Surgery Hospital Universitario Puerta de HierroMajadahondaMadrid 28222Spain department of Internal Medicine Hospital Universitario Puerta de HierroMajadahondaMadrid 28222Spain department of Pathologycal Anatomy Hospital Universitario Puerta de HierroMajadahondaMadrid 28222Spain

BACKGROUND The inflammatory myofibroblastic tumor(IMT)is a rare mesenquimal tumor of doubtful biological behaviour.It’s characterised for affecting mainly children and young adults,although it can appear at any age,being the lungs the primary affected organ(in children it represents 20%of all primary pulmonary tumors).CASE SUMMARY We present the case of a 45 year old woman,with a computed tomography(CT)finding of injury on the anterior surface of the fundus/gastric body and a solid perigastric injury of 12 mm in the ecoendoscopy.The case is presented in the tumor committee deciding to perform a laparoscopic wedge resection.The histological diagnosis was a IMT.The diagnosis is based on imaging tests like the abdominal CT,abdominal ecography and the ecoendoscopy but to confirm the diagnosis a pathological study is necessary.CONCLUSION Due to the unpredictable nature of this tumor,surgical resection is the best therapeutic option.

关键词： Inflammatory myofibroblastic tumor Gastric Wedge resection ALK-mutation Case report

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Management of betablocked patients after sustained virological response in hepatitis C cirrhosis

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World Journal of Gastroenterology 2019年第21期25卷 2665-2674页

作者： Marta Abadía María Luisa Montes Dolores Ponce Consuelo Froilán Miriam Romero Joaquín poza Teresa Hernández Rubén Fernández-Martos Antonio Olveira Antonio Olveira Servicio de Aparato DigestivoHospital Universitario La PazMadrid 28046Spain Unidad VIH Servicio de Medicina InternaHospital Universitario La PazMadrid 28046Spain Servicio de Radiología Hospital Universitario La PazMadrid 28046Spain CIBERehd IdiPAZ Madrid 28029Spain

BACKGROUND Current guidelines do not address the post–sustained virological response management of patients with baseline hepatitis C virus (HCV) cirrhosis and oesophageal varices taking betablockers as primary or secondary prophylaxis of variceal bleeding. We hypothesized that in some of these patients portal hypertension drops below the bleeding threshold after sustained virological response, making definitive discontinuation of the betablockers a safe option. AIM To assess the evolution of portal hypertension, associated factors, non-invasive assessment, and risk of stopping betablockers in this population. METHODS Inclusion criteria were age > 18 years, HCV cirrhosis (diagnosed by liver biopsy or transient elastography > 14 kPa), sustained virological response after directacting antivirals, and baseline oesophageal varices under stable, long-term treatment with betablockers as primary or secondary bleeding prophylaxis. Main exclusion criteria were prehepatic portal hypertension, isolated gastric varices, and concomitant liver disease. Blood tests, transient elastography, and upper gastrointestinal endoscopy were performed. Hepatic venous pressure gradient (HVPG) was measured five days after stopping betablockers. Betablockers could be stopped permanently if gradient was der treatment with propranolol or carvedilol: median age 64 years, men 54.5%, median Model for End-Stage Liver Disease (MELD) score 9, Child-Pugh score A 77%, median platelets 77.000 × 103/μL, median albumin 3.9 g/dL, median baseline transient elastography 24.8 kPa, 88% of patients received primary prophylaxis. Median time from end of antivirals to gradient was 67 wk. Venous pressure gradient was decrease from baseline. On endoscopy, variceal size regressed in 19/27 patients (70%), although gradient was ≥ 12 mmHg in 12/19 patients. The elastography a

关键词： Hepatitis C virus Oesophageal varices Portal hypertension Betablocker Variceal bleeding

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Endoscopic management of esophageal varices

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World Journal of Gastrointestinal Endoscopy 2012年第7期4卷 312-322页

作者： Joaquin poza Cordon Consuelo Froilan Torres Aurora Burgos García Francisco Gea Rodriguez Jose Manuel Suárez de Parga Hospital Universitario la Paz 28046 Madrid Spain

The rupture of gastric varices results in variceal hemorrhage, which is one the most lethal complications of cirrhosis. Endoscopic therapies for varices aim to reduce variceal wall tension by obliteration of the varix. The two principal methods available for esophageal varices are endoscopic sclerotherapy (EST) and band ligation (EBL). The advantages of EST are that it is cheap and easy to use, and the injection catheter fits through the working channel of a diagnostic gastroscope. Endoscopic variceal ligation obliterates varices by causing mechanical strangulation with rubber bands. The following review aims to describe the utility of EBL and EST in different situations, such as acute bleeding, primary and secondary

关键词： Endoscopy Gastrointestinal bleeding Portal hypertension Prophylaxis Esophageal varices

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