| Theme |
Development of surveillance methods for colitic cancer -- From pit pattern to molecular biology |
| Title |
Differences between pit patterns in ordinary colorectal cancer and colitic cancer |
| Author |
Miwa Sada |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Kiyonori Kobayashi |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Kaoru Yokoyama |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Tomoe Katsumata |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Masahiro Igarashi |
Endoscopy Division, Cancer Institute Ariake Hospital |
| [ Summary ] |
A high incidence of dysplasia and colitic cancer has been reported in patients with long term ulcerative colitis (UC), Therefore, cancer surveillance is recommended. In ordinary colonoscopic views, a granular or nodular protrusion or flat elevations as well as redness are signs of dysplasia or colitic cancer. Magnifying colonoscopy with indigo-carmine or crystal violet staining, may display type IIIs, IIIL, IV, V pit (tumorous pit) patterns in patients with dysplasia or early colitic cancer. It is difficult to distinguish between sporadic colorectal adenoma, associated with cancer and dysplasia or colitic cancer with tumorous pits, but the pit density in the latter is slightly lower. Points which may determine dysplasia (early colitic cancer) or sporadic adenoma (cancer) are the following: macroscopic type, pit density, presence or absence of dysplasia in surrounding areas, and results of staining with p53.
A combination of chromoendoscopy and magnifying colonoscopy is useful for the surveillance of dysplasia and colitic cancer in patients with UC. |