Background:Inflammatory bowel diseases (IBDs) have been associated with a higher risk of colorectal cancer (CRC) development and chronic colonic inflammation seems to have a critical role in the pathogenesis of CRC in patients suffering from IBD. In respect to that, surveillance colonoscopy at regular intervals is recommended in patients with colitis.Objective:This review aims to explore the chemopreventive potential of a range of agents, including mesalazine, thiopurines, anti-TNF agents, statins, ursodeoxycholic acid, aspirin, folic acid, and nutraceuticals.Results:These agents target inflammation, oxidative stress, and oncogenic pathways, thereby offering the potential to reduce the risk of CRC in patients with IBD. Anti-TNF agents, such as infliximab and adalimumab, not only reduce colonic inflammation, but also play a protective role against CRC by lessening the carcinogenic effects associated with prolonged inflammatory processes. Furthermore, mesalazine and thiopurines have demonstrated established efficacy, while newer biologics, including interleukin inhibitors, show promising advancements. Although nutraceuticals and dietary interventions require further clinical validation, they offer additional possibilities for non-pharmacological prevention.Conclusion:Despite progress, knowledge gaps persist regarding the long-term safety, optimal dosing, and combined use of these agents. A significant reduction in the incidence of CRC in patients with IBD could be achieved by advancing chemoprevention and personalizing strategies.
背景：炎症性肠病（IBD）与结直肠癌（CRC）发病风险升高相关，慢性结肠炎症在IBD患者CRC的发病机制中似乎起着关键作用。鉴于此，建议对结肠炎患者定期进行监测性结肠镜检查。 目的：本综述旨在探讨一系列药物的化学预防潜力，包括美沙拉嗪、硫嘌呤类药物、抗肿瘤坏死因子（TNF）制剂、他汀类药物、熊去氧胆酸、阿司匹林、叶酸以及营养保健品。 结果：这些药物靶向炎症、氧化应激和致癌通路，从而可能降低IBD患者的CRC风险。抗TNF制剂，如英夫利西单抗和阿达木单抗，不仅能减轻结肠炎症，还能通过减少与长期炎症过程相关的致癌效应，发挥预防CRC的保护作用。此外，美沙拉嗪和硫嘌呤类药物已证实具有明确疗效，而包括白细胞介素抑制剂在内的新型生物制剂则显示出有前景的进展。尽管营养保健品和饮食干预需要进一步的临床验证，但它们为非药物预防提供了额外的可能性。 结论：尽管取得了进展，但在这些药物的长期安全性、最佳剂量以及联合使用方面仍存在知识空白。通过推进化学预防和个性化策略，有望显著降低IBD患者的CRC发病率。
肿瘤(癌症)患者之家