| [ Summary ] |
An increased risk of ulcerative colitis-associated cancer (UCAC) has been reported in patients with long-standing ulcerative colitis. Therefore, cancer surveillance is recommended. Because it is difficult to detect dysplasia occuring in the flat mucosa, current practice guidelines recommend surveillance programs using random biopsy specimens. However, satisfactory results have not been obtained with this technique. It is essential in terms of early detection of UCAC to understand the characteristics of endoscopic findings for those lesions. Clinical features and macroscopic findings, including the mucosal color of 43 cases (71 lesions) UCAC and dysplasia with retrospective follow-up, were analysed. Twenty six out of the 43 (60.5%) were in the clinical active stage and all 71 lesions were surrounded by severe or moderately active inflammation. Fifty three lesions out of 71 (74.6%) were located in the rectum and sigmoid colon. In 53 lesions related to early UCAC and dysplasia, forty two lesions (79%) were of the protruded type, 11 lesions (21%) were of the superficial type including the flat and/or depressed type. Most lesions, especially of the superficial type, were observed to be red. We would like to emphasize that selection of patients in high risk groups and careful examination using chromoendoscopy are essential to detect dysplatic flat or plaque-like elevated lesions which present with faint redness. We hope for the development of new endoscopic techniques, including magnifying endoscopy, to detect flat dysplastic lesions. |