| Theme | Colorectal cancer in ulcerative colitis | |
|---|---|---|
| Title | Step biopsies for detection of dysplasia during surveillance colonoscopy in patients with ulcerative colitis | |
| Publish Date | 2005/01 | |
| Author | Kimitaka Suzuki | Fuji Clinic |
| Author | Toshiaki Watanabe | Division of Surgical Oncology, Department of Surgery, The University of Tokyo |
| Author | Keisuke Hata | Division of Surgical Oncology, Department of Surgery, The University of Tokyo |
| Author | Hirokazu Nagawa | Division of Surgical Oncology, Department of Surgery, The University of Tokyo |
| [ Summary ] | The majority of dysplastic lesions have been difficult to diagnose with surveillance colonoscopy in patients with ulcerative colitis. This is because dysplasia may often be patchy in its distribution. Dysplastic foci may also be found in flat normal appearing mucosa. Thus, multiple step biopsies at regular intervals in the large intestine are currently recommended for routine surveillance. The probability of detection of dysplasia correlates with the number of biopsy specimens taken during surveillance. Approximately 20 biopsies may be an adequate number because these enable the preoperative dysplasia findings to correlate well with the findings from surgical specimens. Recent studies suggest that chromoendoscopy or magnifind endoscopic imaging allows significantly better targeted biopsies compared with conventional colonoscopy using step biopsies. However, some cases of dysplasia with flat mucosa may have complications from very advanced carcinoma. With the aim of reducing mortality, patients may still be offered random step biopsies, the purpose of which is to detect patients who have an especially high risk of cancer. |
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