| Theme |
Colorectal cancer in ulcerative colitis |
| Title |
Endoscopic diagnosis of dysplasia related colitic cancer |
| 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 |
Tsukasa Takeuchi |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| [ Summary ] |
The number of colitic cancer cases has increased with the increase in the number of ulcerative colitis (UC) patients. Detection of dysplasia is important to avoid cancer deaths. Chromoendoscopy and magnifying endoscopy are useful for the detection of DALM (dysplasia-associated lesion or mass) and colitic cancer. Various forms of dysplasia and colitic cancer, especially those with flat shapes and unclear margins are difficult to find. Redness is an important factor in the detection of dysplasia and colitic cancer. In addition, flat elevations, and nodular or granular mucosa are important factors in the recognition of dysplasia. In some cases, dye spraying indicates flat dysplasia spreading around an elevated lesion. Dysplasia and colitic cancer present pit pattern types IIIs, III1, IV or V. The limitations of pit pattern diagnosis for dysplasia and colitic cancer are ; (1) the necessity to inspect the mucosa in the remission stage, (2) good sensitivity, but lack of specificity. The depth of tumor invasion is unclear in some mucinous carcinoma cases. Under the present conditions, precise discrimination of neoplastic and non-neoplastic UC mucosa is difficult using only colonoscopy. However, targeted biopsies have enabled us to diagnose dysplasia and colitic cancer with better efficiency. |