BACKGROUND: In patients with long-standing ulcerative colitis (UC), current dysplasia surveillance guidelines recommend four-quadrant biopsies every 10 cm throughout the colon. However, this may be inefficient if neoplastic lesions are localized in particular segments of the colorectum. The aim was to determine whether a difference exists in the anatomic distribution of dysplasia discovered in UC patients undergoing colonoscopic surveillance. METHODS: From an institutional database of over 700 patients with UC who underwent two or more surveillance colonoscopies between 1994-2006, we identified all patients with flat (endoscopically invisible) low-grade dysplasia (fLGD) or advanced neoplasia (colorectal cancer [CRC] or high-grade dysplasia [HGD]). Pathology reports were reviewed regarding the anatomic location of all dysplastic lesions. Fisher's exact test was used to compare the frequencies of neoplasia among the different colonic segments. RESULTS: We identified 103 patients who progressed to any neoplasia (fLGD, HGD, or CRC). These patients underwent a total of 396 colonoscopies. The mean age at first surveillance colonoscopy was 48.6 years, with a mean UC disease duration of 18.2 years; 100% had extensive disease. Fifty-five patients developed advanced neoplasia. The rectosigmoid was found to have a significantly greater number of biopsies positive for advanced neoplasia and for any neoplasia compared to all other colonic segments (P < 0.0007); 71.2% of all advanced neoplasia was in the rectosigmoid. CONCLUSIONS: The majority of dysplastic lesions identified in a surveillance program was detected in the rectosigmoid. Endoscopists should consider taking a greater percentage of biopsies in these segments as opposed to more proximal areas.
BACKGROUND: In patients with long-standing ulcerative colitis (UC), current dysplasia surveillance guidelines recommend four-quadrant biopsies every 10 cm throughout the colon. However, this may be inefficient if neoplastic lesions are localized in particular segments of the colorectum. The aim was to determine whether a difference exists in the anatomic distribution of dysplasia discovered in UC patients undergoing colonoscopic surveillance. METHODS: From an institutional database of over 700 patients with UC who underwent two or more surveillance colonoscopies between 1994-2006, we identified all patients with flat (endoscopically invisible) low-grade dysplasia (fLGD) or advanced neoplasia (colorectal cancer [CRC] or high-grade dysplasia [HGD]). Pathology reports were reviewed regarding the anatomic location of all dysplastic lesions. Fisher's exact test was used to compare the frequencies of neoplasia among the different colonic segments. RESULTS: We identified 103 patients who progressed to any neoplasia (fLGD, HGD, or CRC). These patients underwent a total of 396 colonoscopies. The mean age at first surveillance colonoscopy was 48.6 years, with a mean UC disease duration of 18.2 years; 100% had extensive disease. Fifty-five patients developed advanced neoplasia. The rectosigmoid was found to have a significantly greater number of biopsies positive for advanced neoplasia and for any neoplasia compared to all other colonic segments (P < 0.0007); 71.2% of all advanced neoplasia was in the rectosigmoid. CONCLUSIONS: The majority of dysplastic lesions identified in a surveillance program was detected in the rectosigmoid. Endoscopists should consider taking a greater percentage of biopsies in these segments as opposed to more proximal areas.
Authors: K K Gkouskou; M Ioannou; G A Pavlopoulos; K Georgila; A Siganou; G Nikolaidis; D C Kanellis; S Moore; K A Papadakis; D Kardassis; I Iliopoulos; F A McDyer; E Drakos; A G Eliopoulos Journal: Oncogene Date: 2015-08-17 Impact factor: 9.867
Authors: Triana Lobatón; Daniel Azuara; Francisco Rodríguez-Moranta; Carolina Loayza; Xavier Sanjuan; Javier de Oca; Ana Fernández-Robles; Jordi Guardiola; Gabriel Capellá Journal: World J Gastroenterol Date: 2014-08-14 Impact factor: 5.742
Authors: J Torres; C Palmela; H Brito; X Bao; H Ruiqi; P Moura-Santos; J Pereira da Silva; A Oliveira; C Vieira; K Perez; S H Itzkowitz; J F Colombel; L Humbert; D Rainteau; M Cravo; C M Rodrigues; J Hu Journal: United European Gastroenterol J Date: 2017-05-05 Impact factor: 4.623
Authors: Mohammad Hadi Imanieh; Ali Goli; Mohammad Hossein Imanieh; Bita Geramizadeh Journal: Iran Red Crescent Med J Date: 2014-12-27 Impact factor: 0.611