| Theme |
Colorectal cancer in ulcerative colitis |
| Title |
Problems in treatment of sporadic adenoma and dysplasia with ulcerative colitis |
| Author |
Masahiro Igarashi |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Miwa Sada |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Kiyonori Kobayashi |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Shigeru Yosizawa |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Tomoe Katsumata |
Department of Gastroenterology, Kitasato University East Hospital |
| [ Summary ] |
This paper reviewed problems with treatment of sporadic adenoma and dysplasia with ulcerative colitis. The subjects had 117 lesions with of 65 patients having sporadic adenoma and 21 lesions seen in 21 patients having dysplasia, as seen in our hospital. The diagnosis of sporadic adenoma is as follows : 1) lesions being seen outside of colitis, 2) peduncle lesions or sub-peduncle lesions with smooth surfaces, as well as thick pit presentation, 3) if the lesions are inside the colitis, dysplasia being absent in other locus, 4) p53 expression being negative and being diagnosed with histology. Dysplasia was characterised as follows : flat, granular and nodular lesions, dysplasia with reddish areas, seen with normal observation. Tumor like pit patterns were observed in all lesions. Therefore it is not difficult to diagnose endoscopically. Endoscopic resection is adequate for sporadic adenoma, however, follow up colonoscopy was necessary each following year because there was a risk of colon cancer. On the other hand, low grade dysplasia (LGD) should be followed up on at six month intervals. Colectomy should be done when a lesion is diagnosed as high grade dysplasia. It is concluded that correct diagnosis of lesions which are seen to be sporadic adenoma or dysplasia is most important in deciding on the correct treatment plan. |