With advances in the treatment of Crohn’s disease (CD), the number of long-term cases is increasing, along with the incidence of CD-related cancers. Here, we discuss the clinical features, diagnosis, treatment, prognosis, and surveillance of CD-related cancers. There are regional differences in the common sites and histological types of CD-related cancers, with right-sided colon cancer accounting for 40% of cases in Europe and the US, and squamous cell carcinoma being common. In Japan, rectal and anal cancers account for 80% of cases, and mucinous carcinoma is common. The prognosis of CD-associated colon cancer and sporadic colon cancer is the same; however, the prognosis of CD-associated rectal cancer is clearly worse than that of sporadic rectal cancer. Early diagnosis is important to improve the prognosis of CD-associated rectal cancer, and it is necessary to establish a surveillance method for CD-associated cancer that combines colonoscopy, anesthetic proctoscopy, and imaging, as appropriate. The basic treatment for CD-related cancer is surgical resection; however, the criteria for selecting the surgical procedure are unclear, and there is no clear evidence for multidisciplinary perioperative treatment including chemotherapy and radiotherapy. Additionally, CD-related rectal and anal cancers have a higher local recurrence rate than that of sporadic rectal cancers; therefore, thorough local control is important. Furthermore, CD-related cancers have different epidemiologies in different regions; therefore, unique diagnostic and treatment strategies must be established for each region.
随着克罗恩病（CD）治疗手段的进步，长期患病病例不断增加，CD相关癌症的发病率也随之上升。本文探讨了CD相关癌症的临床特征、诊断、治疗、预后及监测。CD相关癌症的常见部位和组织学类型存在地区差异：在欧美地区，右侧结肠癌占病例的40%，鳞状细胞癌较为常见；而在日本，直肠癌和肛门癌占病例的80%，黏液腺癌较为常见。CD相关结肠癌与散发性结肠癌的预后相同，但CD相关直肠癌的预后明显差于散发性直肠癌。早期诊断对于改善CD相关直肠癌的预后至关重要，有必要建立结合结肠镜、麻醉下直肠镜及影像学检查的CD相关癌症监测方法。CD相关癌症的基本治疗手段是手术切除，但手术方式的选择标准尚不明确，且包括化疗和放疗在内的多学科围手术期治疗缺乏明确证据。此外，CD相关直肠癌和肛门癌的局部复发率高于散发性直肠癌，因此彻底的局部控制十分重要。另外，CD相关癌症在不同地区的流行病学特征存在差异，各地区需建立独特的诊断与治疗策略。
肿瘤(癌症)患者之家