BACKGROUND & AIMS: Patients with primary sclerosing cholangitis (PSC) and ulcerative colitis (UC) have a high risk of colonic neoplasia. Neoplasia frequently develops in the proximal colon in patients with PSC. Histologic inflammation is an independent risk factor for the development of neoplasia; we investigated whether patients with UC and PSC have more subclinical disease activity than patients with UC alone. METHODS: We performed a retrospective analysis of data from 143 patients (205 examinations) with ulcerative pancolitis who were in clinical remission and treated at a tertiary medical center from May 2011 through May 2016. Endoscopic and histologic activity were compared between patients with PSC (from 36 examinations) and without PSC (from 169 examinations). Disease activity was scored per colonic segment using a modified Mayo endoscopic subscore and histologic assessment. In each colonic segment, differences in disease activity and the degree of discordance between endoscopic and histologic inflammation among UC patients with and without PSC were compared. RESULTS: Patients with UC-PSC had significantly more subclinical endoscopic (odds ratio [OR], 4.21; 95% CI, 1.67-10.63) and histologic activity (OR, 5.13; 95% CI, 2.25-11.68) in the right colon, as well as greater degree of histologic than endoscopic inflammation in the proximal colon (OR, 3.14, 95% CI, 1.24-7.97), compared with patients without PSC. Patients with UC-PSC had significantly less histologic activity in the rectum on multivariate analysis (OR, 0.24; 95% CI, 0.08-0.72). CONCLUSIONS: Patients with UC and PSC who are in clinical remission are significantly more likely to have endoscopic and histologic inflammation in the right colon than patients with UC without PSC. Our findings provide insight into cause of colorectal cancer in UC patients with PSC.
BACKGROUND & AIMS:Patients with primary sclerosing cholangitis (PSC) and ulcerative colitis (UC) have a high risk of colonic neoplasia. Neoplasia frequently develops in the proximal colon in patients with PSC. Histologic inflammation is an independent risk factor for the development of neoplasia; we investigated whether patients with UC and PSC have more subclinical disease activity than patients with UC alone. METHODS: We performed a retrospective analysis of data from 143 patients (205 examinations) with ulcerative pancolitis who were in clinical remission and treated at a tertiary medical center from May 2011 through May 2016. Endoscopic and histologic activity were compared between patients with PSC (from 36 examinations) and without PSC (from 169 examinations). Disease activity was scored per colonic segment using a modified Mayo endoscopic subscore and histologic assessment. In each colonic segment, differences in disease activity and the degree of discordance between endoscopic and histologic inflammation among UC patients with and without PSC were compared. RESULTS:Patients with UC-PSC had significantly more subclinical endoscopic (odds ratio [OR], 4.21; 95% CI, 1.67-10.63) and histologic activity (OR, 5.13; 95% CI, 2.25-11.68) in the right colon, as well as greater degree of histologic than endoscopic inflammation in the proximal colon (OR, 3.14, 95% CI, 1.24-7.97), compared with patients without PSC. Patients with UC-PSC had significantly less histologic activity in the rectum on multivariate analysis (OR, 0.24; 95% CI, 0.08-0.72). CONCLUSIONS:Patients with UC and PSC who are in clinical remission are significantly more likely to have endoscopic and histologic inflammation in the right colon than patients with UC without PSC. Our findings provide insight into cause of colorectal cancer in UC patients with PSC.
Authors: Stuart R Cairns; John H Scholefield; Robert J Steele; Malcolm G Dunlop; Huw J W Thomas; Gareth D Evans; Jayne A Eaden; Matthew D Rutter; Wendy P Atkin; Brian P Saunders; Anneke Lucassen; Paul Jenkins; Peter D Fairclough; Christopher R J Woodhouse Journal: Gut Date: 2010-05 Impact factor: 23.059
Authors: Annika Bergquist; Anders Ekbom; Rolf Olsson; Dan Kornfeldt; Lars Lööf; Ake Danielsson; Rolf Hultcrantz; Stefan Lindgren; Hanne Prytz; Hanna Sandberg-Gertzén; Sven Almer; Fredrik Granath; Ulrika Broomé Journal: J Hepatol Date: 2002-03 Impact factor: 25.083
Authors: David T Rubin; Dezheng Huo; Jami A Kinnucan; Mina S Sedrak; Nicole E McCullom; Alana P Bunnag; Elin P Raun-Royer; Russell D Cohen; Stephen B Hanauer; John Hart; Jerrold R Turner Journal: Clin Gastroenterol Hepatol Date: 2013-07-17 Impact factor: 11.382
Authors: Matthew Rutter; Brian Saunders; Kay Wilkinson; Steve Rumbles; Gillian Schofield; Michael Kamm; Christopher Williams; Ashley Price; Ian Talbot; Alastair Forbes Journal: Gastroenterology Date: 2004-02 Impact factor: 22.682
Authors: Roy M Soetikno; Otto S Lin; Paul A Heidenreich; Harvey S Young; Michael O Blackstone Journal: Gastrointest Endosc Date: 2002-07 Impact factor: 9.427
Authors: B Christensen; D Micic; P R Gibson; A Yarur; E Bellaguarda; P Corsello; J N Gaetano; J Kinnucan; V L Rao; S Reddy; S Singh; J Pekow; D T Rubin Journal: Aliment Pharmacol Ther Date: 2018-01-29 Impact factor: 8.171
Authors: Johan Vessby; Maria Lampinen; Mikael Åberg; Fredrik Rorsman; Agneta Siegbahn; Alkwin Wanders; Marie Carlson Journal: Ups J Med Sci Date: 2019-11-27 Impact factor: 2.384
Authors: Fotios S Fousekis; Vasileios I Theopistos; Ioannis V Mitselos; Alexandros Skamnelos; Athanasios Kavvadias; Konstantinos H Katsanos; Dimitrios K Christodoulou Journal: J Clin Med Res Date: 2019-01-05