Unit:
Κατεύθυνση Χειρουργική ΟγκολογίαLibrary of the School of Health Sciences
Author:
Themelidi Vasiliki
Supervisors info:
Θεοδοσόπουλος Θεοδόσιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Φραγκουλίδης Γεώργιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Βεζάκης Αντώνιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
ΙΦΝΕ και κολοορθικός καρκίνος
Translated title:
IBD and colorectal cancer
Summary:
Patients with inflammatory bowel disease (IBD) are at increased risk of developing colorectal cancer (CRC), despite decreases in CRC incidence in recent years. Chronic inflammation is the driver of neoplastic progression, resulting in dysplastic precursor lesions that may arise in multiple areas of the colon through a process of field cancerization. Colitis-associated CRC shares many molecular similarities with sporadic CRC, and preclinical investigations have demonstrated a potential role for the microbiome in concert with the host immune system in the development of colitis-associated colorectal cancer (CAC). Some unique molecular differences occur in CAC, but their role in the pathogenesis and behavior of inflammation-associated cancers remains to be elucidated. Low-grade dysplasia develops on a background of mucosa that has been genetically altered by chronic inflammation and is at increased risk of malignant progression. Inflammation can induce mutations and the relapsing–remitting nature of this inflammation with proliferative epithelial that accelerates evolution. It is also worth noting that the risk of CRC is significantly higher in male patients with longer disease duration, extensive disease, IBD diagnosis at young age and simultaneous occurrence of primary sclerosing cholangitis .
IBD associated CRC is characterized by less rectal tumors and more synchronous and poorly differentiated tumors compared with sporadic cancer. Patients with IBD-associated CRC appear to have worse survival than those with sporadic CRC. However, it is not possible to detect a difference in overall survival based on gender distribution or initial stage of disease at diagnosis. In subgroups based on age, this difference appears to be driven by young (<65 years old) patients with IBD. Therefore, the recommended operation in case of dysplasia/cancer is proctocolectomy with ileal pouch-anal anastomosis, taking into consideration oncologic principles.
Main subject category:
Health Sciences
Keywords:
Inflammatory bowel disease, Colorectal cancer, IBD
File:
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ΔΙΠΛΩΜΑΤΙΚΗ.pdf
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