Document Detail


Is dysplasia visible during surveillance colonoscopy in patients with ulcerative colitis?
MedLine Citation:
PMID:  18569987     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Patients with ulcerative colitis (UC) have an increased risk of developing colorectal cancer. It was widely believed that dysplastic lesions are invisible on colonoscopy and can only be detected by random biopsies, as 95% of dysplastic lesions occur in flat colonic mucosa indistinct from surrounding tissue. The aim of this study was to determine whether dysplasia is visible during routine surveillance colonoscopy by evaluating only patients who had dysplasia without overt carcinoma. MATERIAL AND METHODS: The medical records, endoscopy and pathology databases were systematically reviewed between 1997 and 2004 at the University of Pennsylvania Health System. Patients with inflammatory bowel disease and dysplasia were identified and their medical charts reviewed. RESULTS: Of the 113 patients with colonic dysplasia confirmed by pathology at our center, 102 (90%) had UC. Forty-nine of the 102 (48%) patients with UC underwent colonoscopic evaluation prior to dysplasia detection. This group was selected as our study cohort. Overall, 72 macroscopic abnormalities were detected at 49 colonoscopies, including 55 polypoid lesions, 12 areas of ulceration, 3 areas of nodularity, 1 irregular hemicircumferential lesion and 1 area of stricture. Overall, 58 dysplastic sites were detected; 51 were macroscopically visible (87.9%) and 7 were macroscopically invisible (12.1%). CONCLUSIONS: Most of the dysplasia in UC is endoscopically visible, but further prospective evaluation of a large number of patients is needed to validate the current observations. Our findings have the potential to modify current recommendations for surveillance biopsies in UC if validated by prospective studies.
Authors:
Wojciech Blonski; Rabi Kundu; James Lewis; Faten Aberra; Mark Osterman; Gary R Lichtenstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  43     ISSN:  1502-7708     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2008  
Date Detail:
Created Date:  2008-06-23     Completed Date:  2008-08-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  698-703     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Department of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-4283, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Colitis, Ulcerative / complications,  pathology*
Colon / pathology*
Colonic Neoplasms / diagnosis*,  etiology,  pathology
Colonic Polyps / diagnosis,  etiology,  pathology
Colonoscopy*
Female
Humans
Intestinal Mucosa / pathology*
Male
Middle Aged
Precancerous Conditions / diagnosis*,  etiology,  pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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