| Theme | Development of surveillance methods for colitic cancer -- From pit pattern to molecular biology | |
|---|---|---|
| Title | Macroscopic appearance of dysplasia and colorectal cancer associated with ulcerative colitis -- endoscopic diagnosis | |
| Publish Date | 2007/01 | |
| Author | Nobuyuki Hida | Division of Lower Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine |
| Author | Takayuki Matsumoto | Division of Lower Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine |
| [ Summary ] | Patients with long standing extensive ulcerative colitis (UC) are at increased risk of developing colorectal neoplastic lesions. Annual surveillance colonoscopy has been recommended to properly diagnose precancerous lesions in such patients. Since colorectal cancer associated with UC is often accompanied by poorly differentiated adenocarcinoma or mucinous adenocarcinoma and a tendency toward early invasion, detection of neoplastic lesions in earlier stages is an important issue. Dysplasia associated with UC has various macroscopic forms, which may be divided into categories with nodular lesions, plaque-like lesions, papillary lesions, polypoid lesions or flat lesions. It is difficult to detect neoplastic lesions associated with UC during surveillance colonoscopy, because such lesions may have unclear margins and may also be found in macroscopically normal flat mucosa. For this reason, current recommended surveillance protocols include multiple random biopsies. Recent advances in videoendoscopic technology allow a new strategy using targeting biopsies for neoplastic lesions. Previous studies have shown that chromoendoscopy and magnifying endoscopy may be useful tools for detection of neoplastic lesions associated with UC. Further investigation of the magnified views of UC associated neoplasia is required to elucidate variations. |
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