Progression of low-grade dysplasia in ulcerative colitis: effect of colonic location

摘要: Background Emerging evidence suggests that the biology of sporadic colorectal neoplasia may differ between proximal and distal colon. Whether such a difference exists in colitis-associated is unknown. Objective To compare rate progression to advanced (AN) dysplasia patients with ulcerative colitis (UC). Design Retrospective cohort study. Setting Tertiary medical center. Patients From an institutional database more than 700 UC who underwent 2 or surveillance colonoscopies 1994 2006, we identified extensive low-grade (LGD). Neoplasia splenic flexure was considered proximal. Main Outcome Measurement Progression AN, defined as high-grade (HGD) cancer (CRC). Results Among 121 LGD, all 7 progressed CRC 6 8 HGD had LGD initially. Subjects significantly shorter time those ( P = .019); 5-year AN-free survivals for were 75 ± 7% 95 3%, respectively (hazard ratio [HR] 5.0; 95% CI, 1.1-22.0). Additionally, flat likely progress raised on univariate testing (HR 3.6; 1.3-10.1). Neither morphology nor sidedness remained significant multivariable testing, although there little change HRs 2.4; 0.8-7.1 morphology; HR 3.5; 0.7-16.8 sidedness) proportional hazards modeling. Limitations Nonrandomized, retrospective trial low incidence AN. Conclusions In long-standing, UC, common progresses rapidly AN LGD.