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Survival after inflammatory bowel disease-associated colorectal cancer in the Colon Cancer Family Registry

World Journal of Gastroenterology 2013年第21期19卷 3241-3248页

作者： Scott V Adams Dennis J Ahnen John A Baron Peter T Campbell Steven Gallinger William m Grady Loic Lemarchand noralane m lindor John D Potter Polly A Newcomb Cancer Prevention Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWA 98109United States Department of medicine Denver VA Medical Center and University of Colorado School of MedicineDenverCO 80045United States Department of medicine University of North CarolinaChapel HillNC 27599United States Epidemiology Research Program Department of Intramural ResearchAmerican Cancer SocietyAtlantaGA 30303United States Division of General Surgery University of TorontoTorontoON M5G2C4Canada Cancer Research Center of Hawaii University of HawaiiHonoluluHI 96813United States Department of Health Science Research Mayo Clinic ArizonaScottsdaleAZ 85259United States

AIm: To investigate the survival of individuals with colorectal cancer (CRC) with inflammatory bowel disease (IBD-associated CRC) compared to that of individuals without IBD diagnosed with CRC. mETHODS: Epidemiologic, clinical, and follow-up data were obtained from the Colon Cancer Family Registry (Colon CFR). IBD-associated cases were identified from self-report of physician diagnosis. For a subset of participants, medical records were examined to confirm self-report of IBD. Cox proportional hazards regression was applied to estimate adjusted hazard ratios (aHR) and 95%CI of mortality, comparing IBD-associated to non-IBD-associated CRC, adjusted for age at CRC diagnosis, sex, Colon CFR phase, and number of prior endoscopies. Following imputation to complete CRC stage information, adjustment for CRC stage was examined. RESULTS: A total of 7202 CRC cases, including 250 cases of IBD-associated CRC, were analyzed. Over a twelve year follow-up period following CRC diagnosis, 2013 and 74 deaths occurred among non-IBD associated CRC and IBD-associated CRC patients, respectively. The difference in survival between IBD-associated and non-IBD CRC cases was not statistically significant (aHR = 1.08; 95%CI: 0.85-1.36). However, the assumption of proportional hazards necessary for valid inference from Cox regression was not met over the entire follow-up period, and we therefore limited analyses to within five years after CRC diagnosis when the assumption of proportional hazards was met. Over this period, there was evidence of worse prognosis for IBD-associated CRC (aHR = 1.36; 95%CI: 1.05-1.76). Results were similar when adjusted for CRC stage, or restricted to IBD confirmed in medical records. CONCLUSION: These results support the hypothesis that IBD-associated CRC has a worse prognosis than non-IBD-associated CRC.

关键词： Colorectal cancer Inflammatory bowel disease Outcomes research Cancer survival Inflammation

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Cancer risk in primary sclerosing cholangitis: Epidemiology,prevention, and surveillance strategies

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World Journal of Gastroenterology 2019年第6期25卷 659-671页

作者： Brian m Fung Keith D lindor James H Tabibian UCLA-Olive View Internal medicine Residency Program Olive View-UCLA Medical Center Office of the University Provost Arizona State University Division of Gastroenterology Department of MedicineOlive View-UCLA Medical Center

Primary sclerosing cholangitis(PSC) is a rare cholestatic liver disease characterized by progressive fibroinflammatory destruction of the intra-and/or extrahepatic biliary ducts. While its features and disease course can be variable,most patients with PSC have concurrent inflammatory bowel disease and will eventually develop liver cirrhosis and end-stage liver disease, with liver transplantation representing the only potentially curative option. Importantly,PSC is associated with a significantly increased risk of malignancy compared to the general population, mainly cholangiocarcinoma, gallbladder carcinoma,hepatocellular carcinoma, and colorectal cancer, with nearly 50% of deaths in patients with PSC being due to cancer. Therefore, robust surveillance strategies are needed, though uncertainty remains regarding how to best do so. In this review, we discuss the epidemiology, prevention, and surveillance of cancers in patients with PSC. Where evidence is limited, we present pragmatic approaches based on currently available data and expert opinion.

关键词： Bile duct diseases Cholangiocarcinoma Gallbladder carcinoma Hepatocellular carcinoma Colorectal cancer Chemoprotection Inflammatory bowel disease

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结直肠癌患者mLH1和mSH2基因突变的转变分析

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美国医学会杂志（中文版） 2006年第2期25卷 83-83页

作者： Graham Casey noralane m. lindor Nickolas Papadopoulos 许峰（译）祝学光（校）

背景：准确发现、解释结直肠癌患者错配修复基因的种系突变对临床治疗至关重要。近来的资料表明，错配修复突变具有高度的异质性，仅凭常规DNA测序无法检测到许多突变。

关键词：直肠癌患者基因突变 mSH2 mLH1 错配修复基因 DNA测序临床治疗种系突变异质性

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阿仑膦酸钠可改善原发性胆汁性肝硬化患者的骨密度:一项随机、安慰剂对照研究

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世界核心医学期刊文摘（胃肠病学分册） 2006年第4期2卷 44-45页

作者： Zein C.O Jorgensen R.A Clarke B. K.D. lindor 陈瑜 Division of Gastroenterology and Hepatology Mayo Clinic and Foundation 200 1st Street SW Rochester MN 55905 United StatesDr.

Bone loss is a well-recognized complication of primary biliary cirrhosis (PBC). Although it has been suggested that alendronate might improve bone mineral density (BmD) in PBC, no randomized placebo-controlled trial has been conducted. The primary aim of this study was to compare the effects of alendronate versus p lacebo on BmD and biochemical measurements of bone turnover in patients with PBC -associated bone loss. We conducted a double- blinded, randomized, placebo-controlled trial. Patients with a PBC and BmD t score of less than -1.5 were randomized to receive 70 mg per week of alendronat e or placebo over 1 year. BmD of the lumbar spine and proximal femur were measur ed at entry and at 1 year. Changes from baseline in BmD and biochemical measurem ents of bone turnover were assessed. Thirty-four patients were enrolled. Sevent een patients were randomized to each arm. After 1 year, a significantly larger i mprovement (P = .005) in spine BmD was observed in the alendronate group (0.09 ±0.03 g/cm2 SD from baseline) comparedwith the placebo group (-0.003±0.02 g/c m2 SD from baseline). A larger improvement (P = .046)was also observed in the fe moral BmD of alendronate patients versus placebo. BmD changes were independent o f concomitant estrogen therapy. The rate of adverse effects was similar in both groups. In conclusion, in patients with PBC-related bone loss, alendronate sign ificantly improves BmD compared with placebo. Although in this study oral alendr onate appears to be well tolerated in patients with PBC, larger studies are need ed to formally evaluate safety.

关键词：阿仑膦酸钠骨密度安慰剂对照骨丢失雌激素治疗股骨近端副作用发生率随机研究双盲研究持续

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