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Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review

机译：组织学炎症增加溃疡性结肠炎大肠肿瘤的风险：系统评价

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Background/Aims Ulcerative colitis (UC) patients are at greater risk for the development of colorectal neoplasia. Several individual studies have demonstrated associations between severity of histologic inflammation and colorectal neoplasia. However, a comprehensive systematic review has not been completed. We performed a systematic review and meta-analysis to explore the relationship between histologic inflammation and risk for neoplasia among available observational studies. Methods Three databases (EMBASE, MEDLINE and the Cochrane Library) were systematically searched. Studies were included if they included UC patients who underwent colonoscopic assessment and when histologic inflammation and colorectal neoplasia were both reported. Colorectal neoplasia rates were compared. Quantitative meta-analysis was attempted. Results Four of 1,422 records found were eligible. Results from 2 case-control studies reported a 3.5-fold increased risk for colorectal neoplasia associated with a single point increase in histologic inflammation. This result was further corroborated by one cohort study that demonstrated increased hazard ratios. The second cohort study reported outcomes for patients with normal gross endoscopy, but had increased histological inflammation when neoplasia was assessed. Finally, this study reported increased risk for neoplastic progression by histological inflammation among patients who were normal by gross endoscopic evaluation. Quantitative meta-analysis was unsuccessful due to heterogeneity between study measures. Conclusions There is strong evidence that histologic inflammation among patients with UC increases the risk of colorectal neoplasia. The depth and nature of assessment of additional clinical variables was varied and may have resulted in greater outcome discrepancy. Additional study related to mechanisms of inflammation-related neoplasia and therapeutic modification is needed.
机译：背景/目的溃疡性结肠炎（UC）患者发生结直肠瘤的风险更大。几项单独的研究表明，组织学炎症的严重程度与结直肠肿瘤之间存在关联。但是，尚未完成全面的系统审查。我们进行了系统的综述和荟萃分析，以探讨组织学炎症与瘤形成风险之间的关系。方法系统地搜索了三个数据库（EMBASE，MEDLINE和Cochrane库）。如果他们包括接受结肠镜检查的UC患者，并且同时报告了组织学炎症和大肠肿瘤，则纳入研究。比较大肠癌形成率。尝试进行定量荟萃分析。结果在1,422条记录中有4条符合条件。两项病例对照研究的结果报告，与组织学炎症单点增加相关的结直肠瘤形成风险增加了3.5倍。一项队列研究进一步证实了这一结果，该研究表明危险比增加。第二项队列研究报道了总体内窥镜检查正常的患者的结局，但在评估肿瘤时其组织学炎症增加了。最后，该研究报告了通过大体内镜评估正常的患者中，由组织学炎症引起的肿瘤进展风险增加。由于研究措施之间的异质性，未能进行定量荟萃分析。结论有强有力的证据表明UC患者的组织学炎症会增加结直肠癌的风险。评估其他临床变量的深度和性质各不相同，可能导致更大的结果差异。还需要与炎症相关的瘤形成和治疗修饰有关的其他研究。

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