潰瘍性大腸炎の長期予後

The Long-Term Prognosis of Ulcerative Colitis

潰瘍性大腸炎（UC）に対する昨今の内科的治療の進歩は目覚ましく，重症例の割合や要入院加療率は低下傾向を示している．また，治療の目標として臨床症状の改善のみならず，内視鏡的粘膜治癒を目指すことで，長期の寛解維持，さらに手術率の減少が得られている．罹患範囲は，必ずしも発症時の範囲で維持されるわけではなく，長期経過中に少なからず口側進展を認める．一方，長期罹患例における癌・dysplasiaの合併による手術例が増加している．UCの生命予後は良好とされるが，癌・dysplasiaを早期に発見するためにサーベイランス内視鏡検査が重要である．

　The activity of UC（ulcerative colitis）has been shown to be decreasing year by year. Recently, medical treatment has made remarkable progress followed by a decline in hospitalization and the ratio of severe cases. Moreover, because of a treat-to-target approach, the goal of endoscopic mucosal healing as well as improvement in clinical symptoms may enable long-term remission and a decreased operation rate. Diseased areas not infrequently progress to the oral side. In the long-term follow-up of UC patients, the incidence of surgery due to cancer/dysplasia is increasing. Although UC patients usually have a normal life expectancy, surveillance colonoscopy is important to detect cancer/dysplasia as early as possible.