Microscopic Colitis Is Associated With a Reduced Risk of Colorectal Adenoma and Cancer: A Meta-Analysis

Background The study sought to conduct a systematic review and meta-analysis of the risk of colorectal adenoma or cancer in patients with microscopic colitis (MC). Methods A comprehensive literature search of PubMed and EMBASE databases was performed. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated to examine the effect of MC on the risk of colorectal adenoma or cancer. Results Twelve studies reporting the outcomes of 50 795 patients with MC were eligible for this meta-analysis. MC was negatively associated with the risk of colorectal adenoma compared with participants without MC (RR, 0.44; 95% CI, 0.33-0.58; P < .001; I2 = 87.3%). Also, the rate of colorectal cancer was lower in the patients with MC compared with the general population (RR, 0.62; 95% CI, 0.43-0.89; P = .01; I2 = 91.6%). In addition, sensitivity and subgroup analyses indicated that the results were robust. Conclusions The present systematic review indicated that patients with MC may be associated with a lower risk of colorectal adenoma or cancer. The clinical data support the current professional society guideline. A surveillance colonoscopy program is not recommended as standard for patients with MC.

Evaluation Of Laryngeal Vascular Changes With Image1 S Enhancement System In Reference To The European Laryngological Society Guideline

Objectives: To assess the feasibility of using Image1 S™ endoscopic enhancement system for discrimination of the vascular patterns in laryngeal lesions. Design: Forty patients presenting with benign, dysplastic and malign laryngeal lesions were examined with Image1 S system. The vascular patterns were classified by a group of the authors/ according to the ELS guideline, as perpendicular or longitudinal, in all lesions. Endoscopic images of the vascular patterns are evaluated through an online survey by a group of otolaryngologists with different levels of clinical expertise. The qualitative evaluation of the vascular patterns in two groups were compared to investigate the consistency. The relationship between the vascular patterns and the pathological results was statistically analyzed. Results: Eleven patient presented with benign, 13 patients with dysplastic and 16 patients with malignant pathology. The vascular patterns were longitudinal in 9 lesions, perpendicular in 28 lesions and undetectable in 3 lesions. The relevance between the vascularization pattern and the pathological diagnosis was found to be significant (χ2= 20.30, p < 0,001). The qualitative evaluation of the vascular patterns by the two groups of observers was significantly close to each other (=0.63). The survey also showed that spectral modes producing high contrast images were preferred by 81,9% of the participants over white light images. Conclusion: This study demonstrated the usefulness and feasibility of Image1 S endoscopic enhancement system to predict the diagnosis from vascular changes in laryngeal lesions.