ENDOSCOPIC DIAGNOSIS OF DYSPLASIA IN PATIENTS WITH LONGSTANDING ULCERATIVE COLITIS

AIM: to evaluate high-definition colonoscopy (HD-WLE) using chromoendoscopy for dysplasia in the longstanding ulcerative colitis (UC).PATIENTS AND METHODS: a cohort prospective study included 140 patients (aged 29-79 years old) with a long course of UC (6-44 years) in time of endoscopic remission with good quality of bowel cleansing. A white-light endoscopy was performed using high-definition colonoscopies (HD-WLE). Chromoendoscopy (0.4% solution of indigo carmine), targeted biopsy, and histological analysis were performed.RESULTS: HD-WLE revealed 34 lesions with endoscopic signs of dysplasia in 27 (19.3%) patients: in 20 patients – 1 (74.1%) lesion, in 7 patients 2 (25.9%). In 22 patients (64.7%) lesions were more than 1 cm.Chromoendoscopy confirmed the signs of dysplasia in 100.0% of cases (88.2% – low grade dysplasia).Histologically, low-grade dysplasia was detected in 58.8% of cases, undetected dysplasia – in 20.6%, sporadic adenomas – in 20.6%.The effectiveness of endoscopic diagnosis for detecting dysplasia was 74%. A comparative analysis of the endoscopic signs of dysplasia and sporadic adenomas showed the absence of significant differences.CONCLUSION: the additional chromoendoscopy during HD-WLE colonoscopy with targeted biopsy does not lead to increase of colorectal epithelial dysplasia detection in UC.The experience of endoscopist should be considered when making decision which type of endoscopy for dysplasia detection in UC is needed.

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P254. Clinical implications of low-grade dysplasia detected during surveillance of IBD patients: a closer look at chromoendoscopy and high-definition white light endoscopy

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjw019.373 ◽

2016 ◽

Vol 10 (suppl 1) ◽

pp. S220-S221

Keyword(s):

White Light ◽

Clinical Implications ◽

Low Grade ◽

High Definition ◽

White Light Endoscopy ◽

Low Grade Dysplasia

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572 Clinical Implications of Low-Grade Dysplasia Detected During Surveillance of IBD Patients: A Closer Look at Chromoendoscopy and High-Definition White Light Endoscopy

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2016.03.111 ◽

2016 ◽

Vol 83 (5) ◽

pp. AB153

Author(s):

Joren Ten Hove ◽

Erik Mooiweer ◽

Andrea Van Der Meulen ◽

Evelien Dekker ◽

Cyriel Ponsioen ◽

...

Keyword(s):

White Light ◽

Clinical Implications ◽

Low Grade ◽

High Definition ◽

White Light Endoscopy ◽

Low Grade Dysplasia

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Is the diagnosis of low-grade dysplasia in ulcerative colitis consistent?

Gastroenterology ◽

10.1016/s0016-5085(01)83648-9 ◽

2001 ◽

Vol 120 (5) ◽

pp. A733-A733

Author(s):

C LIM ◽

A AXON ◽

A VAIL ◽

D FORMAN ◽

M DIXON

Keyword(s):

Ulcerative Colitis ◽

Low Grade ◽

Low Grade Dysplasia

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Time-gated fluorescence spectroscopy improves endoscopic detection of low-grade dysplasia in ulcerative colitis

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2009.09.029 ◽

2010 ◽

Vol 71 (2) ◽

pp. 312-318 ◽

Cited By ~ 8

Author(s):

Maria-Anna Ortner ◽

Virginia Fusco ◽

Bernd Ebert ◽

Uwe Sukowski ◽

Jutta Weber-Eibel ◽

...

Keyword(s):

Ulcerative Colitis ◽

Fluorescence Spectroscopy ◽

Low Grade ◽

Low Grade Dysplasia

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P397 Surveillance in ulcerative colitis: Can we predict the risk for intraepithelial neoplasia?

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.526 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S368-S369

Author(s):

J Estorninho ◽

P Freire ◽

S Lopes ◽

M Ferreira ◽

...

Keyword(s):

Ulcerative Colitis ◽

Disease Duration ◽

Intraepithelial Neoplasia ◽

Screening Colonoscopy ◽

Low Grade ◽

Surveillance Colonoscopy ◽

High Quality ◽

Increased Risk ◽

History Of ◽

Low Grade Dysplasia

Abstract Background Ulcerative colitis (UC) has been associated with an increased risk of colorectal cancer (CRC). Although dye spray chromoendoscopy showed superiority to standard colonoscopy in surveillance studies, with the availability of higher-resolution colonoscopes, the utility of chromoendoscopy (CE) has been questioned. We aimed to evaluate the risk of intraepithelial neoplasia (IN) after a high-quality screening colonoscopy (making use of CE or random biopsies (RB) and removing all detected lesions) in a population with longstanding UC and to identify potential risk factors for dysplasia incidence. Methods In a previous study, 145 patients with clinically and endoscopic longstanding (≥8 yr) distal/extensive UC without primary sclerosing cholangitis and/or history of IN were prospectively randomised to undergo CE or RB. In this study, after a median follow-up of 5 additional years, we evaluated subsequent IN incidence in these patients, submitted to surveillance colonoscopy. Patients without high-quality surveillance colonoscopy (with good bowel preparation and cecum intubation) using high-definition were excluded. Results One hundred and twenty-one patients were included. Nine had removed adenomas with low-grade dysplasia in the index colonoscopy. Now, in surveillance colonoscopy, we detected 9 (7.4%) IN: low-grade dysplasia was found in 8 (6.6%) patients and a colorectal adenocarcinoma in 1 (0.008%) patient. After multivariate analysis, IN was significantly associated with older age (68 vs. 52 years, p < 0.05) and higher disease duration (26 vs. 20 years, p < 0.05). No association was found between IN and previous detection of IN in screening colonoscopy sex, the CE or RB use in index colonoscopy, extent of disease, The presence of pseudopolyps, smoking habits, familial history of CRC or maintenance therapy for UC. Conclusion In this study, older patients and higher disease duration were associated with a higher risk of IN in surveillance colonoscopy.

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