Are dysplasia and colorectal cancer endoscopically visible in patients with ulcerative colitis

摘要: Background Dysplasia and colorectal cancer (CRC) in ulcerative colitis (UC) develop via pathways distinct from sporadic CRC may occur flat mucosa indistinct surrounding tissue. Surveillance guidelines, therefore, have emphasized the `roach of periodic endoscopic examinations systematic random biopsies involved mucosa. Given imperfect nature this approach, recent work has focused on improved surveillance techniques suggests that neoplasia is endoscopically visible many patients. Objective To assess visibility dysplasia UC. Design This was a retrospective review used University Chicago Inflammatory Bowel Disease Registry clinical administrative database. All cases or UC between November 1994 October 2004 were identified. The approach to these patients included both at approximately 10-cm intervals throughout colon directed polypoid lesions, masses, strictures, irregular inflamed Findings endoscopy compared with pathologic findings biopsy surgical specimens. Visible defined as lesion reported by endoscopist led confirmed pathology. Invisible diagnosed pathology but not described endoscopy. Per-lesion per-patient sensitivities determined. Setting Tertiary referral center. Patients Database inflammatory bowel disease seen Chicago. Main Outcome Measurements Endoscopically neoplasia. Results In database, there 1339 622 Forty-six found median age 48 years duration 20 years. Of patients, 77% had pancolitis, 21% left-sided colitis, 2% proctitis. These 128 (median 3 per patient; range, 1-9 patient), and, 51 examinations, 75 separate dysplastic cancerous lesions identified (mean, 1.6 standard deviation, 1.3). Thirty-eight 65 (58.5%) 8 10 cancers (80.0%) 23 polyps 1 stricture, 22 for were 71.8% 100%, respectively. overall per-lesion 61.3% 76.1%, Limitations Retrospective databases medical records. Conclusions are most be reliably during scheduled examinations. Future guidelines should incorporate information.