Effect of Biologics on the Risk of Advanced-Stage Inflammatory Bowel Disease-Associated Intestinal Cancer: A Nationwide Study

被引：10

作者：

Seishima, Ryo ^{[1
]}

Okabayashi, Koji ^{[1
]}

Ikeuchi, Hiroki ^{[2
]}

Uchino, Motoi ^{[2
]}

Futami, Kitaro ^{[3
]}

Noguchi, Tatsuki ^{[4
]}

Ohge, Hiroki ^{[5
]}

Iseki, Yasuhito ^{[6
]}

Watanabe, Kazuhiro ^{[7
]}

Itabashi, Michio ^{[8
]}

Okamoto, Kinya ^{[9
]}

Toiyama, Yuji ^{[10
]}

Ogino, Takayuki ^{[11
]}

Nakamura, Masafumi ^{[12
]}

Yamada, Kazutaka ^{[13
]}

Wakai, Toshifumi ^{[14
]}

Sato, Yu ^{[15
]}

Kimura, Hideaki ^{[16
]}

Takahashi, Kenichi ^{[17
]}

Hida, Koya ^{[18
]}

Kinugasa, Yusuke ^{[19
]}

Ishida, Fumio ^{[20
]}

Okuda, Junji ^{[21
]}

Daito, Koji ^{[22
]}

Koyama, Fumikazu ^{[23
]}

Ueno, Hideki ^{[24
]}

Yamamoto, Takayuki ^{[25
]}

Yamamoto, Seiichiro ^{[26
]}

Hanai, Tsunekazu ^{[27
]}

Maemoto, Atsuo ^{[28
]}

Arakaki, Junya ^{[29
]}

Komori, Koji ^{[30
]}

Akagi, Yoshito ^{[31
]}

Shida, Dai ^{[32
]}

Yamaguchi, Shigeki ^{[33
]}

Matsuda, Keiji ^{[34
]}

Maeda, Kiyoshi ^{[35
]}

Noake, Toshihiro ^{[36
]}

Nezu, Riichiro ^{[37
]}

Sasaki, Shin ^{[38
]}

Hasegawa, Junichi ^{[39
]}

Sunami, Eiji ^{[40
]}

Kanemitsu, Yukihide ^{[41
]}

Katsumata, Kenji ^{[42
]}

Uehara, Kei ^{[43
]}

Kiyomatsu, Tomomichi ^{[44
]}

Suto, Takeshi ^{[45
]}

Kazama, Shinsuke ^{[46
]}

Yamada, Takeshi ^{[47
]}

Goi, Takenori ^{[48
]}

机构：

[1] Keio Univ, Sch Med, Dept Surg, Tokyo, Japan

[2] Hyogo Med Univ, Dept Gastroenterol Surg, Div Inflammatory Bowel Dis, Nishinomiya, Hyogo, Japan

[3] Fukuoka Univ, Dept Surg, Chikushi Hosp, Fukuoka, Japan

[4] Univ Tokyo, Dept Surg Oncol, Tokyo, Japan

[5] Hiroshima Univ Hosp, Dept Infect Dis, Hiroshima, Japan

[6] Osaka Metropolitan Univ, Grad Sch Med, Surg Med, Osaka, Japan

[7] Tohoku Univ, Sch Med, Dept Surg, Sendai, Miyagi, Japan

[8] Tokyo Womens Med Univ, Dept Surg, Div Inflammatory Bowel Dis Surg, Tokyo, Japan

[9] Japan Community Hlth Care Org, Tokyo Yamate Med Ctr, Tokyo, Japan

[10] Mie Univ, Grad Sch Med, Dept Gastrointestinal & Paediat Surg, Tokyo, Japan

[11] Osaka Univ, Grad Sch Med, Dept Gastrointestinal Surg, Osaka, Japan

[12] Kyushu Univ, Grad Sch Med Sci, Dept Surg & Oncol, Fukuoka, Japan

[13] Takano Hosp, Coloproctol Ctr, Kumamoto, Japan

[14] Niigata Univ, Div Digest & Gen Surg, Niigata, Japan

[15] Toho Univ, Sakura Med Ctr, Dept Surg, Chiba, Japan

[16] Yokohama City Univ, Inflammatory Bowel Dis Ctr, Med Ctr, Yokohama, Kanagawa, Japan

[17] Tohoku Rosai Hosp, Inflammatory Bowel Dis Ctr, Sendai, Miyagi, Japan

[18] Kyoto Univ, Grad Sch Med, Dept Gastrointestinal Surg, Kyoto, Japan

[19] Tokyo Med & Dent Univ, Dept Gastrointestinal Surg, Tokyo, Japan

[20] Showa Univ, Northern Yokohama Hosp, Digest Dis Ctr, Yokohama, Kanagawa, Japan

[21] Osaka Med & Pharmaceut Univ, Canc Ctr, Osaka, Japan

[22] Kindai Univ, Fac Med, Dept Surg, Osaka, Japan

[23] Nara Med Univ, Dept Surg, Nara, Japan

[24] Natl Def Med Coll, Dept Surg, Saitama, Japan

[25] Japan Community Hlth Care Org, Yokkaichi Hazu Med Ctr, Yokaichi, Mie, Japan

[26] Tokai Univ, Dept Digest Syst Surg, Sch Med, Hiratsuka, Kanagawa, Japan

[27] Fujita Hlth Univ, Sch Med, Dept Surg, Toyoake, Aichi, Japan

[28] Sapporo Higashi Tokushukai Hosp, Inst Biomed Res, Sapporo, Hokkaido, Japan

[29] Urasoe Gen Hosp Okinawa, Ctr Gastroenterol, Dept Surg, Urasoe, Japan

[30] Aichi Canc Ctr Hosp, Dept Gastroenterol Surg, Nagoya, Aichi, Japan

[31] Kurume Univ, Dept Surg, Sch Med, Fukuoka, Japan

[32] Univ Tokyo, Inst Med Sci, Dept Surg, Tokyo, Japan

[33] Saitama Med Univ, Dept Gastrointestinal Surg, Int Med Ctr, Saitama, Japan

[34] Teikyo Univ, Sch Med, Dept Surg, Tokyo, Japan

[35] Osaka City Gen Hosp, Dept Gastroenterol Surg, Osaka, Japan

[36] Kurume Coloproctol Ctr, Fukuoka, Japan

[37] Nishinomiya Municipal Cent Hosp, Dept Surg, Nishinomiya, Hyogo, Japan

[38] Japanese Red Cross Med Ctr, Dept Coloproctol Surg, Tokyo, Japan

[39] Osaka Rosai Hosp, Dept Surg, Osaka, Japan

[40] Kyorin Univ, Dept Surg, Tokyo, Japan

[41] Natl Canc Ctr, Dept Colorectal Surg, Tokyo, Japan

[42] Tokyo Med Univ, Dept Gastrointestinal & Paediat Surg, Tokyo, Japan

[43] Nagoya Univ, Dept Surg, Div Surg Oncol, Grad Sch Med, Nagoya, Aichi, Japan

[44] Natl Ctr Global Hlth & Med, Dept Surg, Tokyo, Japan

[45] Yamagata Prefectural Cent Hosp, Dept Gastroenterol Surg, Yamagata, Japan

[46] Saitama Canc Ctr, Div Gastroenterol Surg, Saitama, Japan

[47] Nippon Med Sch, Dept Gastrointestinal & Hepatobiliary Pancreat Sur, Tokyo, Japan

[48] Univ Fukui, Fac Med Sci, Dept Surg 1, Fukui, Japan

[49] Niigata Univ, Grad Sch Med & Dent Sci, Div Mol & Diagnost Pathol, Niigata, Japan

[50] Tokyo Med & Dent Univ, Dept Surg, Tokyo, Japan

来源：

AMERICAN JOURNAL OF GASTROENTEROLOGY | 2023年 / 118卷 / 07期

关键词：

Crohn's disease; ulcerative colitis; IBD-associated intestinal neoplasia; biologics; COLORECTAL NEOPLASIA; ULCERATIVE-COLITIS; PRACTICE GUIDELINES; METAANALYSIS; THIOPURINES; THERAPY; MALIGNANCIES; SURVEILLANCE; INFECTIONS;

D O I：

10.14309/ajg.0000000000002149

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

INTRODUCTION:The aim of this study was to evaluate the effect of biologics on the risk of advanced-stage inflammatory bowel disease (IBD)-associated intestinal cancer from a nationwide multicenter data set.METHODS:The medical records of patients with Crohn's disease (CD) and ulcerative colitis (UC) diagnosed with IBD-associated intestinal neoplasia (dysplasia or cancer) from 1983 to 2020 were included in this study. Therapeutic agents were classified into 3 types: biologics, 5-aminosalicylic acid, and immunomodulators. The pathological cancer stage was compared based on the drug used in both patients with CD and UC.RESULTS:In total, 1,042 patients (214 CD and 828 UC patients) were included. None of the drugs were significantly associated with cancer stage in the patients with CD. In the patients with UC, an advanced cancer stage was significantly associated with less use of biologics (early stage: 7.7% vs advanced stage: 2.0%, P < 0.001), 5-aminosalicylic acid, and immunomodulators. Biologic use was associated with a lower incidence of advanced-stage cancer in patients diagnosed by regular surveillance (biologics [-] 24.5% vs [+] 9.1%, P = 0.043), but this was not the case for the other drugs. Multivariate analysis showed that biologic use was significantly associated with a lower risk of advanced-stage disease (odds ratio = 0.111 [95% confidence interval, 0.034-0.356], P < 0.001).DISCUSSION:Biologic use was associated with a lower risk of advanced IBD-associated cancer in patients with UC but not with CD. The mechanism of cancer progression between UC and CD may be different and needs to be further investigated.

引用

页码：1248 / 1255

页数：8

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