Hereditary colorectal cancer syndromes and inflammatory bowel disease: results from a registry-based study

被引:0
作者
Lauricella, S. [1 ,5 ]
Ricci, M. T. [1 ]
Tontini, G. E. [2 ,3 ]
Cavallaro, F. [2 ]
Rausa, E. [1 ,5 ]
Signoroni, S. [1 ]
Brignola, C. [1 ]
Pasanisi, P. [4 ]
Vitellaro, M. [1 ,5 ]
机构
[1] Fdn IRCCS Ist Nazl Tumori, Hereditary Digest Tract Tumors Unit, Via Giacomo Venezian 1, I-20133 Milan, Italy
[2] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Gastroenterol & Endoscopy Unit, Milan, Italy
[3] Univ Milan, Dept Pathophysiol & Transplantat, Milan, Italy
[4] Fdn IRCCS Ist Nazl Tumori, Nutr Res & Metabol Unit, Milan, Italy
[5] Fdn IRCCS Ist Nazl Tumori, Colorectal Surg Unit, Milan, Italy
关键词
Lynch syndrome; FAP; Ulcerative colitis; Crohn's disease; APC-associated polyposis; Colorectal cancer; LYNCH SYNDROME; RISK; GUIDELINES; CONSENSUS; COLITIS;
D O I
10.1007/s00384-025-04808-x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PurposeIn this study, we investigated the progression of high-grade dysplasia (HGD)/CRC in patients with hereditary colorectal cancer syndromes (HCSS) and concomitant inflammatory bowel diseases (IBDs).MethodsWe described the natural history of a series of patients with confirmed diagnosis of hereditary colorectal cancer syndromes (HCCSs) and concomitant IBDs who were referred to the Hereditary Digestive Tumors Registry at the Fondazione IRCCS Istituto Nazionale dei Tumori of Milan.ResultsBetween January 1989 and April 2024, among 450 patients with APC-associated polyposis and 1050 patients with Lynch syndrome (LS), we identified six patients with IBDs (five with UC, one with ileal penetrating CD) and concomitant HCCSs (five with LS, one with APC-associated polyposis). Three patients developed CRC (two patients with stage IIA, and one with stage IIIA); in one patient, CRC occurred over a median follow-up of 12 months after IBD diagnosis, while in two, both conditions were diagnosed simultaneously. The median age at initial diagnosis of CRC was 33 years (range 27-41). Five patients (83.3%) underwent surgical procedures (three colonic resections for carcinoma and two for other reasons). Most of them progressed to precancerous or cancerous colonic lesions at a young age. Notably, all patients with CRC had a diagnosis of UC.ConclusionIBD patients with coexistent HCCSs can develop early CRC onset at an advanced stage. These patients should be always referred to tertiary referral centers for strict surveillance programs and early surgical management of advanced colorectal neoplastic lesions. Noninvasive biomarkers of neoplastic changes are advocated to further improve the management of IBD patients with HCCSs.
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