AIM: To evaluate the diagnostic accuracy of confocal laser endomicroscopy (CLE) for the detection of dysplasia in long-standing ulcerative colitis (UC). METHODS: We prospectively performed a surveillance colonoscopy in 51 patients affected by long-standing UC. Also, in the presence of macroscopic areas with suspected dysplasia, both targeted contrasted indigo carmine endoscopic assessment and probe-based CLE were performed. Colic mucosal biopsies and histology, utilised as the gold standard, were assessed randomly and on visible lesions, in accordance with current guidelines. RESULTS: Fourteen of the 51 patients (27%) showed macroscopic mucosal alterations with the suspected presence of dysplasia, needing chromoendoscopic and CLE evaluation. In 5 macroscopically suspected cases, the presence of dysplasia was confirmed by histology (3 flat dysplasia; 2 DALMs). No dysplasia/cancer was found on any of the outstanding random biopsies. The diagnostic accuracy of CLE for the detection of dysplasia compared to standard histology was sensitivity 100%, specificity 90%, positive predictive value 83% and negative predictive value 100%. CONCLUSION: CLE is an accurate tool for the detection of dysplasia in long-standing UC and shows optimal values of sensitivity and negative predictivity. The scheduled combined application of chromoendoscopy and CLE could maximize the endoscopic diagnostic accuracy for diagnosis of dysplasia in UC patients, thus limiting the need for biopsies.
AIM: To evaluate the diagnostic accuracy of confocal laser endomicroscopy (CLE) for the detection of dysplasia in long-standing ulcerative colitis (UC). METHODS: We prospectively performed a surveillance colonoscopy in 51 patients affected by long-standing UC. Also, in the presence of macroscopic areas with suspected dysplasia, both targeted contrasted indigo carmine endoscopic assessment and probe-based CLE were performed. Colic mucosal biopsies and histology, utilised as the gold standard, were assessed randomly and on visible lesions, in accordance with current guidelines. RESULTS: Fourteen of the 51 patients (27%) showed macroscopic mucosal alterations with the suspected presence of dysplasia, needing chromoendoscopic and CLE evaluation. In 5 macroscopically suspected cases, the presence of dysplasia was confirmed by histology (3 flat dysplasia; 2 DALMs). No dysplasia/cancer was found on any of the outstanding random biopsies. The diagnostic accuracy of CLE for the detection of dysplasia compared to standard histology was sensitivity 100%, specificity 90%, positive predictive value 83% and negative predictive value 100%. CONCLUSION: CLE is an accurate tool for the detection of dysplasia in long-standing UC and shows optimal values of sensitivity and negative predictivity. The scheduled combined application of chromoendoscopy and CLE could maximize the endoscopic diagnostic accuracy for diagnosis of dysplasia in UC patients, thus limiting the need for biopsies.
Authors: F J C van den Broek; J A van Es; S van Eeden; P C F Stokkers; C Y Ponsioen; J B Reitsma; P Fockens; E Dekker Journal: Endoscopy Date: 2010-12-16 Impact factor: 10.093
Authors: Julia J Liu; Karen L Madsen; Pierre Boulanger; Levinus A Dieleman; Jon Meddings; Richard N Fedorak Journal: J Clin Gastroenterol Date: 2011-03 Impact factor: 3.062
Authors: Anna M Buchner; Victoria Gomez; Michael G Heckman; Muhammad W Shahid; Sami Achem; Kanwar R Gill; Laith H Jamil; Jamil Laith; Michel Kahaleh; Simon K Lo; Michael Picco; Douglas Riegert-Johnson; Massimo Raimondo; Daniela Sciemeca; Herbert Wolfsen; Timothy Woodward; Michael B Wallace Journal: Gastrointest Endosc Date: 2011-03 Impact factor: 9.427
Authors: Julia J Liu; Karen Wong; Aducio L Thiesen; Stephanie J Mah; Levinus A Dieleman; Brian Claggett; John R Saltzman; Richard N Fedorak Journal: Gastrointest Endosc Date: 2011-03-11 Impact factor: 9.427
Authors: Anna M Buchner; Muhammad W Shahid; Michael G Heckman; Murli Krishna; Marwan Ghabril; Muhammad Hasan; Julia E Crook; Victoria Gomez; Massimo Raimondo; Timothy Woodward; Herbert C Wolfsen; Michael B Wallace Journal: Gastroenterology Date: 2009-11-10 Impact factor: 22.682
Authors: Douglas K Rex; David A Johnson; Joseph C Anderson; Phillip S Schoenfeld; Carol A Burke; John M Inadomi Journal: Am J Gastroenterol Date: 2009-02-24 Impact factor: 10.864
Authors: Livia Biancone; Pierre Michetti; Simon Travis; Johanna C Escher; Gabriele Moser; Alastair Forbes; Jörg C Hoffmann; Axel Dignass; Paolo Gionchetti; Günter Jantschek; Ralf Kiesslich; Sanja Kolacek; Rod Mitchell; Julian Panes; Johan Soderholm; Boris Vucelic; Eduard Stange Journal: J Crohns Colitis Date: 2008-01-28 Impact factor: 10.020
Authors: Kenneth K Wang; David L Carr-Locke; Satish K Singh; Helmut Neumann; Helga Bertani; Jean-Paul Galmiche; Razvan I Arsenescu; Fabrice Caillol; Kenneth J Chang; Stanislas Chaussade; Emmanuel Coron; Guido Costamagna; Aldona Dlugosz; S Ian Gan; Marc Giovannini; Frank G Gress; Oleh Haluszka; Khek Y Ho; Michel Kahaleh; Vani J Konda; Frederic Prat; Raj J Shah; Prateek Sharma; Adam Slivka; Herbert C Wolfsen; Alvin Zfass Journal: United European Gastroenterol J Date: 2015-06 Impact factor: 4.623
Authors: Tommaso Gabbani; Natalia Manetti; Andrea Giovanni Bonanomi; Antonio Luca Annese; Vito Annese Journal: World J Gastrointest Endosc Date: 2015-03-16
Authors: Giovanni D De Palma; Gaetano Luglio; Stefania Staibano; Luigi Bucci; Dario Esposito; Francesco Maione; Massimo Mascolo; Gennaro Ilardi; Pietro Forestieri Journal: Surg Endosc Date: 2014-02-12 Impact factor: 4.584
Authors: F Maione; M C Giglio; G Luglio; A Rispo; M D'Armiento; B Manzo; G Cassese; P Schettino; N Gennarelli; S Siciliano; F P D'Armiento; G D De Palma Journal: Tech Coloproctol Date: 2017-07-03 Impact factor: 3.781