| [ Summary ] |
Surveillance colonoscopy (SCF) has been performed to detect dysplasia and surgically treatable carcinoma in patients with ulcerative colitis (UC). SCFs were carried out in 208 patients with longstanding UC of total or left-sided type between 1979 and 1997. Out of 130 patients with total colitis,4 had invasive carcinoma, 6 high-grade dysplasia (HGD), 6 low-grade dysplasia (LGD), and 9 indefinite for dysplasia(IND). Out of 78 patients with left-sided colitis, I had invasive carcinoma, 1 LGD, and 2 IND. The overall incidence of dysplasia including IND cases was 16%, similar to the reported incidence from western countries. All thesepatients who had carcinoma or HGD are alive and well postoperatively during the 6-year follow-up period. On the other hand, all 5 cases withcarcinoma who had never received SCF and had had symptoms suffered fromadvanced carcinoma. Prognosis of non-SCF cancer cases was very poor, and 3 of the 5 cases (60%) died within 2 years and 5 months. These results suggest the usefulness of SCF for early detection of carcinoma inlong-standing UC. Microspectrophotometric DNA measurement and p53 immunostaining have proven to be useful in diagnosing dysplasia associated with UC.A family history of colon cancer may help to refine risk stratification. |