TY - JOUR
T1 - Histological differentiation between sporadic and colitis-associated intestinal cancer in a nationwide study
T2 - A propensity-score-matched analysis
AU - Uchino, Motoi
AU - Ikeuchi, Hiroki
AU - Noguchi, Tatsuki
AU - Okabayashi, Koji
AU - Futami, Kitaro
AU - Tanaka, Shinji
AU - Ohge, Hiroki
AU - Watanabe, Kazuhiro
AU - Itabashi, Michio
AU - Okamoto, Kinya
AU - Okita, Yoshiki
AU - Mizushima, Tsunekazu
AU - Mizuuchi, Yusuke
AU - Yamada, Kazutaka
AU - Shimada, Yoshifumi
AU - Sato, Yu
AU - Kimura, Hideaki
AU - Takahashi, Kenichi
AU - Hida, Koya
AU - Kinugasa, Yusuke
AU - Okuda, Junji
AU - Daito, Koji
AU - Koyama, Fumikazu
AU - Ueno, Hideki
AU - Yamamoto, Takayuki
AU - Hanai, Tsunekazu
AU - Kono, Toru
AU - Kobayashi, Hirotoshi
AU - Ajioka, Yoichi
AU - Sugihara, Kenichi
AU - Ishihara, Soichiro
N1 - Publisher Copyright:
© 2024 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.
PY - 2024/5
Y1 - 2024/5
N2 - Background and Aim: Colitis-associated intestinal cancer (CAC) can develop in patients with inflammatory bowel disease; however, the malignant grade of CAC may differ from that of sporadic colorectal cancer (CRC). Therefore, we compared histological findings distinct from cancer stage between CAC and sporadic CRC to evaluate the features of CAC. Methods: We reviewed the clinical and histological data collected from a nationwide database in Japan between 1983 and 2020. Patient characteristics were compared to distinguish ulcerative colitis (UC), Crohn's disease (CD), and sporadic CRC. Comparisons were performed by using all collected data and propensity score-matched data. Results: A total of 1077 patients with UC-CAC, 297 with CD-CAC, and 136 927 with sporadic CRC were included. Although the prevalence of well or moderately differentiated adenocarcinoma (Tub1 and Tub2) decreased according to tumor progression for all diseases (P < 0.01), the prevalence of other histological findings, including signet ring cell carcinoma, mucinous carcinoma, poorly differentiated adenocarcinoma, or squamous cell carcinoma, was significantly higher in CAC than in sporadic CRC. Based on propensity score-matched data for 982 patients with UC and 268 with CD, the prevalence of histological findings other than Tub1 and Tub2 was also significantly higher in those with CAC. At pT4, mucinous carcinoma occurred at a significantly higher rate in patients with CD (45/86 [52.3%]) than in those with sporadic CRC (13/88 [14.8%]) (P < 0.01). Conclusion: CAC, including early-stage CAC, has a higher malignant grade than sporadic CRC, and this difference increases in significance with tumor progression.
AB - Background and Aim: Colitis-associated intestinal cancer (CAC) can develop in patients with inflammatory bowel disease; however, the malignant grade of CAC may differ from that of sporadic colorectal cancer (CRC). Therefore, we compared histological findings distinct from cancer stage between CAC and sporadic CRC to evaluate the features of CAC. Methods: We reviewed the clinical and histological data collected from a nationwide database in Japan between 1983 and 2020. Patient characteristics were compared to distinguish ulcerative colitis (UC), Crohn's disease (CD), and sporadic CRC. Comparisons were performed by using all collected data and propensity score-matched data. Results: A total of 1077 patients with UC-CAC, 297 with CD-CAC, and 136 927 with sporadic CRC were included. Although the prevalence of well or moderately differentiated adenocarcinoma (Tub1 and Tub2) decreased according to tumor progression for all diseases (P < 0.01), the prevalence of other histological findings, including signet ring cell carcinoma, mucinous carcinoma, poorly differentiated adenocarcinoma, or squamous cell carcinoma, was significantly higher in CAC than in sporadic CRC. Based on propensity score-matched data for 982 patients with UC and 268 with CD, the prevalence of histological findings other than Tub1 and Tub2 was also significantly higher in those with CAC. At pT4, mucinous carcinoma occurred at a significantly higher rate in patients with CD (45/86 [52.3%]) than in those with sporadic CRC (13/88 [14.8%]) (P < 0.01). Conclusion: CAC, including early-stage CAC, has a higher malignant grade than sporadic CRC, and this difference increases in significance with tumor progression.
KW - Colitis-associated cancer
KW - Crohn's disease
KW - Histology
KW - Ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=85183654010&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85183654010&partnerID=8YFLogxK
U2 - 10.1111/jgh.16496
DO - 10.1111/jgh.16496
M3 - Article
C2 - 38273469
AN - SCOPUS:85183654010
SN - 0815-9319
VL - 39
SP - 893
EP - 901
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
IS - 5
ER -