INTESTINE Vol.19 No.4(2-3-1)

Theme Inflammation and cancer in the lower GI tract
Title Endoscopic diagnosis of colorectal cancer associated with ulcerative colitis : From routine endoscopy to magnifying endoscopy
Publish Date 2015/07
Author Yasushi Iwao Center for Preventive Medicine, Keio University Hospital
[ Summary ] Patients with long-standing ulcerative colitis have been reported to be at a high risk for ulcerative colitis-associated cancer (UCAC) ; hence, cancer surveillance is recommended. Because dysplasia occurring in flat mucosa is difficult to detect, clinical practice guidelines recommended surveillance programs that include examination of random biopsy specimens ; however, the results have not been satisfactory. For the early detection of UCAC, understanding the characteristics of the endoscopic findings of the lesions is necessary. Approximately 80 % of UCAC lesions were located in the rectum and the sigmoid colon, and nearly 70 % were of the protruded type. The color of most of the lesions, especially the superficial type, was red. We emphasize that selection of a high-risk group and careful examination using chromoendoscopy is essential for the detection of dysplastic flat or plaque-like elevated lesions that show faint redness.
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