| Theme | Colorectal cancer in ulcerative colitis | |
|---|---|---|
| Title | Colitic cancer ; significance of dysplasia associated lesion or mass (DALM) | |
| Publish Date | 2005/01 | |
| Author | Fumio Konishi | Department of Surgery, Omiya Medical Center, Jichi Medical School |
| Author | Yutaka Kawamura | Department of Surgery, Omiya Medical Center, Jichi Medical School |
| Author | Hironori Yamamoto | Department of Surgery, Jichi Medical School |
| [ Summary ] | The higher risk of developing colorectal cancer for patients with long standing ulcerative colitis is well recognized. Dysplasia is a neoplastic lesion, which is considered to be precancerous. The detection of dysplasia in surveillance colonoscopy for patients with long standing colitis is important in the early detection of colitic cancer. The signficance of “Dysplasia Associated Lesion or Mass ; DALM” in cancer surveillance in cases of colitis was first reported by Blackstone in 1981. The frequency of detecting definite dysplasia is higher in DALM than in flat mucosa. Higher detection rates for DALM with endoscopy is an important issue. Recent reports, using dye spray endoscopy, and / or magnifying endoscopy presented better results for endoscopic DALM detection. The histological diagnosis of dysplasia in biopsy specimens is usually made according to Riddell's classification in Western countries and with the Japanese criteria in this country. With the help of immunostaining, such as p53 and β-catenin, the histological diagnosis of dysplasia will become more accurate, and thus surveillance colonoscopy will become more helpful in detecting cancer associated with colitis in the early stages. | |