| Theme |
Development of diagnosis of magnifying endoscopy |
| Title |
Magnifying endoscopic diagnosis of dysplasia in patients with ulcerative colitis |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Toshifumi Hibi |
Department of Internal Medicine, Keio University School of Medicine |
| Author |
Takayuki Matsumoto |
Division of Lowar Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine |
| Author |
Kazuo Ohtsuka |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Hiroshi Kashida |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Osamu Ito |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shigeharu Hamatani |
Department of Pathology, Showa University Northern Yokohama Hospital |
| [ Summary ] |
The risk for colorectal cancer is high in patients with long standing ulcerative colitis (UC). Surveillance colonoscopy with step biopsies for detecting dysplasia is recommended, despite of its inefficiencies, because of the difficulties associated with diagnosing early stage cancer. Recent advances in magnifying colonoscopy have changed this situation. In ordinary view of colonoscopy, mass, redness, abnormal vessels and stenosis are signs of dysplasia. With chromoendoscopy and magnifying colonoscopy, dysplasia and early UC associated cancer display type IIIL, IIIS, IV or VI pit patterns. Those pit patterns are characterized by irregularities, varying sizes, thin distribution, wide-open or fused type pits. There are some problems with this diagnostic modality, for example, non neoplastic regions sometimes show type IIIL-like or IV-like pit patterns. It is difficult to distinguish between sporadic cancer and UC associated neoplasms. However, magnifying colonoscopy is useful for diagnosing early colorectal caner, associated with UC. |