KMID : 0356720090250030150
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Journal of the Korean Society of Coloproctology 2009 Volume.25 No. 3 p.150 ~ p.156
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Malignancy Associated with Inflammatory Bowel Disease
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Shin Ui-Sup
Kim Chan-Wook Yu Chang-Sik Yoon Sang-Nam Lim Seok-Byung Song Joon-Seon Kim Jin-Cheon Park Jin-Seok Jung Kwang-Yong
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Abstract
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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 (¡¾8.8), and the mean duration of IBD at the time of diagnosis of the cancer was 12.6 yr (¡¾6.0). 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.
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KEYWORD
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Inflammatory bowel dieseas, Colorectal cancer, Mucinous adenocarcinoma, Lymphoma, Squamous cell carcinoma
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