INTESTINE Vol.11 No.1(4)

Theme Development of surveillance methods for colitic cancer -- From pit pattern to molecular biology
Title Pit pattern diagnosis of ulcerative colitis associated cancer
Publish Date 2007/01
Author Shin-ei Kudo Digestive Disease Center, Showa University Northern Yokohama Hospital
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 Kenichi Mizuno Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Junichi Ukegawa Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Shigeharu Hamatani Department of Pathology, Showa University Northern Yokohama Hospital
[ Summary ] Early diagnosis of ulcerative colitis (UC) associated cancer is still difficult. Recently, the endoscopic surveillance atlas for UC associated cancer was published. Macroscopically, mass, redness, abnormal vessels, and stenosis are the signs of dysplasia. A conference concerning pit pattern of UC associated cancer was held in 2005. During the conference, 40 cases from various institutes were analyzed and the following subjects were discussed : Use of chromoendoscopy and magnifying colonoscopy, dysplasia and early UC associated cancer displaying type IIIL, IIIs, IV or VI pit pattern. Many of these lesions show type IV and are subclassified into branched, serrated, or villous patterns. Those pit patterns of UC associated cancer are termed neoplastic pit patterns of ulcerative colitis (NPUC). They are distinguished by nonNPUC with irregularities, various sizes, scattered large or fusion type pits. Some problems still remaining are that atypical lesions are sometimes difficult to distinguish from inflammatory or regenerated mucosa and that distinguishing between UC-associated neoplasms and sporadic cancer is often difficult. More cases of this type should be analyzed to improve diagnosis of UC associated cancer.
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