scholarly journals Advanced neoplasia detection using chromoendoscopy and white light colonoscopy for surveillance in patients with inflammatory bowel disease

2020 ◽  
Vol 18 (4) ◽  
pp. 438-446
Author(s):  
Kyeong Ok Kim ◽  
Michael V. Chiorean
Keyword(s):  
Inflammatory Bowel Disease ◽  
White Light ◽  
Bowel Disease ◽  
Paired Comparison ◽  
Interval Cancer ◽  
White Light Endoscopy ◽  
Advanced Neoplasia ◽  
Serrated Lesions ◽  
Inflammatory Bowel ◽  
The Impact

Background/Aims: Chromoendoscopy (CE) has been shown to be superior to white light endoscopy (WLE) for neoplasia detection in inflammatory bowel disease (IBD). We aimed to compare the yield of CE and WLE for the detection of overall neoplasia and advanced neoplasia in IBD. Methods: Patients who underwent surveillance colonoscopy from 1999 to 2017 were identified from our IBD database. CE procedures were compared with their respective WLE controls in a paired comparison, and frequency of all neoplasia, advanced neoplasia, and serrated neoplasia was assessed for both targeted and random biopsies.Results: A total of 290 procedures performed in 98 individuals were identified with a median follow-up 4 years (median 3 colonoscopies/patient). CE and WLE were performed in 159 and 131 episodes, respectively. CE detected neoplasia in 40.9% of colonoscopies versus 23.7% with WLE (<i>P</i>= 0.002). In addition, CE detected more advanced neoplasia (18.2% vs. 6.1%, <i>P</i>= 0.002) and serrated lesions (14.5% vs. 6.1%, <i>P</i>= 0.022). Significantly fewer samples were obtained per procedure with CE (14.9 ± 9.7 vs. 20.9 ± 11.1, <i>P</i>< 0.001). Cancer was diagnosed in 2 cases.Conclusions: CE has a higher detection rate than WLE for advanced neoplasia and serrated lesions in patients with IBD under surveillance. Further prospective studies evaluating the impact of CE on decreasing the risk of interval cancer and colectomy in IBD patients are warranted.

scholarly journals P307 Colorectal neoplasia risk in patients with inflammatory bowel disease and serrated lesions

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S307-S308
Author(s):  
M De Jong ◽  
S Vos ◽  
I Nagtegaal ◽  
Y van Herwaarden ◽  
L Derikx ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Colorectal Neoplasia ◽  
Classification Systems ◽  
Advanced Neoplasia ◽  
Increased Risk ◽  
Serrated Lesions ◽  
Inflammatory Bowel ◽  
Serrated Lesion ◽  
The Impact

Abstract Background The presence of serrated lesions (SLs) is an established risk factor for colorectal neoplasia development in the general population. However, the impact of SLs on the colorectal neoplasia risk in inflammatory bowel disease (IBD) patients is unknown. In addition, SLs might have been misclassified in IBD patients in the past, in part due to revisions of classification systems. Presently, SLs are categorised as hyperplastic lesions, sessile SLs, and traditional serrated adenomas. We aimed (1) to compare the colorectal neoplasia risk in IBD patients with SLs vs. IBD patients without SLs, and 2) to study the subclassification of SLs in IBD patients before and after histopathological review by two expert gastrointestinal pathologists. Methods We identified all IBD patients with colonic SLs from 1996 to 2019 in a tertiary referral centre using the local histopathology database. Patients with neoplasia prior to SL diagnosis were excluded. Clinical data from patients’ charts were retrieved until June 2019. A subgroup of 135 SLs was reviewed by two pathologists. The log-rank analysis was used to compare the cumulative (advanced) neoplasia incidence in IBD patients with SL vs. IBD patients without SL undergoing surveillance in the same time period. Patients were censored at the end of surveillance or at colectomy. Results We identified 376 SLs in 204 IBD patients (61.9% ulcerative colitis (UC)). In the original reports, 91.9% was classified as a hyperplastic lesion. After histopathological review, 120/136 (88%) of the SLs were confirmed (16 were no SL). Of the 120 confirmed SLs, 62.2% was classified as a sessile SL, 37.8% as a hyperplastic lesion, and 0.8% as a traditional serrated adenoma. The mean time from IBD diagnosis to the first serrated lesion was 14.3 ( ± 12.3) years. A total of 41/204 (20.0%) of patients developed neoplasia (3 CRC, 3 HGD, and 35 LGD; including 2 HGD and 17 LGD at the moment of serrated lesion detection). In the 304 patients without SL (52.6% UC), 63 developed neoplasia (20.7%; 8 CRC, 5 HGD and 50 LGD). Patients who received follow-up colonoscopies after SL (n = 127) had an increased cumulative risk of neoplasia (p &lt; 0.01), but no increased risk of advanced neoplasia (p = 0.50) compared with the group of IBD patients without SL (Figure 1). Conclusion The presence of SLs in IBD patients was associated with a relatively high risk of synchronous colorectal neoplasia as well as an increased risk of subsequent neoplasia, although not with an increased risk of advanced neoplasia. Histopathological review confirmed the SL diagnosis in the majority of lesions, although a large proportion of the hyperplastic lesions was reclassified as a sessile SL.

Sa1727 - Chromoendoscopy Versus High Definition White Light Endoscopy for Dysplasia Detection in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 154 (6) ◽  
pp. S-371
Author(s):  
Ramprasad Jegadeesan ◽  
Madhav Desai ◽  
Tharani Sundararajan ◽  
Venkata Subhash Gorrepati ◽  
Viveksandeep Thogulva Chandrasekar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
White Light ◽  
Bowel Disease ◽  
Meta Analysis ◽  
High Definition ◽  
White Light Endoscopy ◽  
Inflammatory Bowel

Incremental diagnostic yield of chromoendoscopy and outcomes in inflammatory bowel disease patients with a history of colorectal dysplasia on white-light endoscopy

2016 ◽  
Vol 83 (5) ◽  
pp. 1005-1012 ◽  
Author(s):  
Parakkal Deepak ◽  
Gregory J. Hanson ◽  
Joel G. Fletcher ◽  
William J. Tremaine ◽  
Darrell S. Pardi ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
White Light ◽  
Bowel Disease ◽  
Diagnostic Yield ◽  
White Light Endoscopy ◽  
History Of ◽  
Inflammatory Bowel

Meta-analysis of Virtual-based Chromoendoscopy Compared With Dye-spraying Chromoendoscopy Standard and High-definition White Light Endoscopy in Patients With Inflammatory Bowel Disease at Increased Risk of Colon Cancer

2020 ◽  
Vol 26 (9) ◽  
pp. 1319-1329 ◽  
Author(s):  
Mohammed El-Dallal ◽  
Ye Chen ◽  
Qianyun Lin ◽  
Shana Rakowsky ◽  
Lindsey Sattler ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
White Light ◽  
Bowel Disease ◽  
Meta Analysis ◽  
High Definition ◽  
Quality Of Evidence ◽  
White Light Endoscopy ◽  
Increased Risk ◽  
Inflammatory Bowel

Abstract Background Patients with inflammatory bowel disease (IBD) have an increased risk of colorectal cancer. We sought to assess the comparative efficacy of virtual chromoendoscopy (VCE) vs high definition white light endoscopy (HDWLE) or dye-spraying chromoendoscopy (DCE) through a meta-analysis and rating the quality of evidence. Methods A systematic review of the literature was performed through February 15, 2019. Primary outcomes were number of patients in whom dysplasia was identified and number of dysplastic lesions identified in these patients. We included only randomized control trials (RCTs) and performed meta-analysis using RevMan5.3. Results Of the 3205 studies identified, 11 RCTs were included, with a total of 1328 patients. Per patient analysis, VCE was not statistically different compared with DCE (risk ratio [RR] 0.77; 95% CI, 0.55–1.08) or HDWLE (RR 0.72; 95% CI, 0.45–1.15). However, per dysplasia analysis, VCE was not statistically different compared with DCE (RR 0.72; 95% CI, 0.47–1.11) and inferior compared with HDWLE (RR 0.62; 95% CI, 0.44–0.88). The quality of evidence was moderate in the HDWLE and low to moderate in the DCE studies. Conclusion Based on this meta-analysis, VCE was as good as HDWLE and DCE in identifying dysplasia per patient analysis. However, per dysplasia analysis, VCE was inferior compared with HDWLE and no different from DCE. Further studies need to examine the efficacy of each individual VCE technique.

P172 CHROMOENDOSCOPY VERSUS HIGH DEFINITION WHITE LIGHT ENDOSCOPY FOR DYSPLASIA DETECTION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

2018 ◽  
Vol 24 (suppl_1) ◽  
pp. S65-S65 ◽  
Author(s):  
Ramprasad Jegadeesan ◽  
Madhav Desai ◽  
Tharani Sundararajan ◽  
Jihan Fathallah ◽  
Venkata Subhash Gorrepati ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
White Light ◽  
Bowel Disease ◽  
Meta Analysis ◽  
High Definition ◽  
White Light Endoscopy ◽  
Inflammatory Bowel
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