scholarly journals Even non-experts identify non-dysplastic lesions in inflammatory bowel disease via chromoendoscopy: results of a screening program in real-life

2019 ◽  
Vol 07 (06) ◽  
pp. E743-E750
Author(s):  
Beatriz Aladrén ◽  
Yago González-Lama ◽  
María García-Alvarado ◽  
Mónica Sierra ◽  
Jésus Barrio ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Negative Predictive Value ◽  
Bowel Disease ◽  
Predictive Value ◽  
Screening Program ◽  
Real Life ◽  
Pit Pattern ◽  
High Negative Predictive Value ◽  
Inflammatory Bowel

Abstract Background and study aims Chromoendoscopy with targeted biopsy is the technique of choice for colorectal cancer screening in longstanding inflammatory bowel disease. We aimed to analyze results of a chromoendoscopy screening program and to assess the possibility of identifying low-risk dysplastic lesions by their endoscopic appearance in order to avoid histological analysis. Materials and methods We retrospectively reviewed chromoendoscopies performed between February 2011 and June 2017 in seven Spanish hospitals in a standardized fashion. We analyzed the findings and the diagnostic yield of the Kudo pit pattern for predicting dysplasia. Results A total of 709 chromoendoscopies (569 patients) were reviewed. Median duration of disease was 16.7 years (SD 8.1); 80.4 % had ulcerative colitis. A total of 2025 lesions (3.56 lesions per patient) were found; two hundred and thirty-two lesions were neoplastic (11.5 %) (223 were LGD (96.1 %), eight were HGD (3.4 %), and one was colorectal cancer (0.5 %). The correlation between dysplasia and Kudo pit patterns predictors of dysplasia (≥ III) was low, with an area under the curve of 0.649. Kudo I and II lesions were correctly identified with a high negative predictive value (92 %), even by non-experts. Endoscopic activity, Paris 0-Is classification, and right colon localization were risk factors for dysplasia detection, while rectum or sigmoid localization were protective against dysplasia. Conclusions Chromoendoscopy in the real-life setting detected 11 % of dysplastic lesions with a low correlation with Kudo pit pattern. A high negative predictive value would prevent Kudo I and, probably, Kudo II biopsies in the left colon, reducing procedure time and avoiding complications.

P.07.18 PREVALENCE OF INFLAMMATORY BOWEL DISEASE (IBD) IN A COLORECTAL CANCER POPULATION SCREENING PROGRAM

2019 ◽  
Vol 51 ◽  
pp. e229-e230
Author(s):  
C. Bezzio ◽  
I. Arena ◽  
G. De Nucci ◽  
C. Della Corte ◽  
M. Devani ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Screening Program ◽  
Population Screening ◽  
Inflammatory Bowel

scholarly journals Biomarkers and Hematological Indices in the Diagnosis of Iron Deficiency in Children with Inflammatory Bowel Disease

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1358 ◽  
Author(s):  
Paulina Krawiec ◽  
Elżbieta Pac-Kożuchowska
Keyword(s):  
Inflammatory Bowel Disease ◽  
Iron Deficiency ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Bowel Disease ◽  
Predictive Value ◽  
Iron Homeostasis ◽  
Added Value ◽  
Predictive Values ◽  
Inflammatory Bowel

Inflammation may affect many routinely available parameters of iron homeostasis. Thus, the recognition of iron deficiency in inflammatory bowel disease (IBD) remains a diagnostic challenge in a clinical routine. The aim of the study was to detect the most efficient marker of iron deficiency in IBD children. In a group of 75 IBD children, we evaluated the sensitivity, specificity, accuracy, and positive and negative predictive values of erythrocytes’ indices, including MCV, MCH, MCHC and RDW, and biochemical markers, including iron, transferrin, sTfR and sTfR/log ferritin, for identifying iron deficiency. Receiver operating characteristic (ROC) analysis was used to compare the ability of these parameters to detect iron deficiency. The best predictors of iron deficiency were sTfR/log ferritin, with accuracy 0.86, sensitivity 0.98, specificity 0.63, positive predictive value 0.83 and negative predictive value 0.94, and sTfR, with accuracy 0.77, sensitivity 0.82, specificity 0.67, positive predictive value 0.82 and negative predictive value 0.67. Moreover, sTfR/log ferritin exhibited the largest area under ROC (0.922), followed by sTfR (0.755) and MCH (0.720). The sTfR/log ferritin index appears to be the most efficient marker of iron depletion in pediatric IBD, and it may give an added value in the management of IBD patients.

scholarly journals P128 Colorectal cancer surveillance with chromoendoscopy in inflammatory bowel disease: results from a real life experience

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S201-S201
Author(s):  
C Rubín De Célix Vargas ◽  
M Chaparro ◽  
J A Moreno ◽  
C Santander ◽  
J P Gisbert
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Endoscopic Resection ◽  
Bowel Disease ◽  
Detection Rate ◽  
Real Life ◽  
Cancer Surveillance ◽  
Inflammatory Bowel ◽  
Colorectal Cancer Surveillance

Abstract Background Patients with inflammatory bowel disease (IBD) are at increased risk for developing colorectal cancer (CRC). Recent practice guidelines suggest the use of chromoendoscopy with targeted biopsies to identify dysplastic lesions. The aim of this study was to know the dysplasia detection rate with chromoendoscopy in a real life cohort and to describe endoscopic characteristics of the lesions detected and their management. Methods Single-centre retrospective and observational study of all chromoendoscopies done between January 2016 and May 2019 in adult patients with left-sided/extensive ulcerative colitis or Crohn’s disease involving more than one-third of the colon. All polyp characteristics were collected (localisation, size, Paris and Kudo classifications) and their treatments received (endoscopic resection or surgery). Results One hundred and eighty-six chromoendoscopies on 160 patients were included. Of all chromoendoscopies, the dysplasia detection rate was 24% (23% of patients had dysplasia in any chromoendoscopy done during the period of the study). Ninety-two patients (57%) were men. Eighty-six (54%) had ulcerative colitis, 72 (45%) Crohn’s disease and 2 (1%) non-classifiable IBD. Twenty-five (15%) had family history of CRC. 118 (74%) received treatment with aminosalicylates, 67 (42%) with thiopurines and 42 (26%) with biologics. A total of 212 lesions were detected, 94% were located in areas of mucosa close to the segment affected by IBD. Most of them were located in the rectum (36%) and left colon (30%). More than half of the lesions were flat polyps (31% Paris 0-IIa, 25% Paris 0-IIb). The most frequent Kudo pit pattern was Kudo II (43%) and Kudo IIIs (33%). A total of 123 (58 %) lesions were non-neoplastic and 74 (35%) were neoplastic. Among these, 69 (93%) were low-grade dysplasia and five were high-grade dysplasia: 5/5 located in rectum, and one of them could not be suitable for endoscopic resection. Twelve lesions could not be retrieved. Only five patients (3%) required surgical treatment. In the univariate analysis, the presence of dysplasia was not related with age, sex, smoking, or type of IBD. Dysplastic lesions were more frequently localised distal to the splenic flexure (OR, 0.543; 95% CI, 0.30–0.99; p < 0.05) compared with non-dysplastic lesions; they were non-polypoid lesions: Paris 0-IIa, 0-IIb, 0-IIc (OR, 0.11; 95% CI, 0.02–0.59; p < 0.001). The polyp size was not a predictor of dysplasia. Conclusion This study reports a high dysplasia detection rate (24%) via targeted chromoendoscopic biopsies in a real life cohort. Endoscopic resection removed the lesions in most of the cases; only 3% of patients need surgery (partial colectomy). Our results underlines the importance of colorectal cancer surveillance in IBD patients.

P757 Prevalence of inflammatory bowel disease (IBD) in a colorectal cancer population screening program

2019 ◽  
Vol 13 (Supplement_1) ◽  
pp. S500-S500
Author(s):  
C Bezzio ◽  
I Arena ◽  
C Della Corte ◽  
M Devani ◽  
G Manes ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Screening Program ◽  
Population Screening ◽  
Inflammatory Bowel
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