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염증성 장질환에 동반된 악성종양

Malignancy Associated with Inflammatory Bowel Disease

대한대장항문학회지 2009년 25권 3호 p.150 ~ 156
신의섭 ( Shin Ui-Sup ) - 울산대학교 의과대학 서울아산병원 외과학교실

김찬욱 ( Kim Chan-Wook ) - 울산대학교 의과대학 서울아산병원 외과학교실
유창식 ( Yu Chang-Sik ) - 울산대학교 의과대학 외과학교실
윤상남 ( Yoon Sang-Nam ) - 울산대학교 의과대학 서울아산병원 외과학교실
임석병 ( Lim Seok-Byung ) - 울산대학교 의과대학 외과학교실
송준선 ( Song Joon-Seon ) - 울산대학교 의과대학 서울아산병원 병리과
김진천 ( Kim Jin-Cheon ) - 울산대학교 의과대학 서울아산병원 대장항문외과학교실
박진석 ( Park Jin-Seok ) - 울산대학교 의과대학 서울아산병원 대장항문외과학교실
정광용 ( Jung Kwang-Yong ) - 울산대학교 의과대학 서울아산병원 대장항문외과학교실

Abstract


Purpose: As the number of patients with inflammatory bowel disease (IBD) has steadily increased in Korea, IBD-associated cancers are expected to increase in number. This study investigated the clinical features of intestinal cancer in patients with IBD.

Methods: One hundred five patients with ulcerative colitis (UC) and 270 patients with Crohn’s disease (CD) under the care of the Department of Colon and Rectal Surgery, Asan Medical Center, between December 1989 and January 2009 were reviewed retrospectively.

Results: Ten patients of the 105 with UC and 5 patients of the 270 with CD were found to have intestinal cancer. The mean age was 45 yr (±8.8), and the mean duration of IBD at the time of diagnosis of the cancer was 12.6 yr (±6.0). Six of the 15 cancer patients had no history of treatment for IBD of more than 3 mo before diagnosis of the cancer. Eleven cancers were located in the rectum (7 in UC, 4 in CD), including 1 case of synchronous cancer. One case of small bowel cancer was found in a patient with small bowel CD. Four cases involved a mucinous adenocarcinoma. Eight of the 12 cases of an adenocarcinoma of the colon and rectum were advanced stage.

Conclusions: IBD-associated intestinal cancers were found at a relatively young age, were diagnosed at an advanced stage, and had a higher proportion of mucinous adenocarcinomas than in sporadic cancer. Considering the increasing incidence of IBD and the expected increase in the number of IBD-associated cancer in Korea, every effort should be made to prevent intestinal cancer in patients with IBD and to detect it early.

키워드

염증성 장질환;대장암;점액암;림프종;편평상피암
Inflammatory bowel dieseas;Colorectal cancer;Mucinous adenocarcinoma;Lymphoma;Squamous cell carcinoma
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