Colonoscopy, Tumors, and Inflammatory Bowel Disease - New Diagnostic Methods

Kießlich, Ralf; Hoffman, Arthur; Neurath, Markus F.

doi:10.1055/s-2005-921122

Cited by 46 publications

(33 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…narrow band imaging (NBI), fluorescence endoscopy, optical coherence tomography or confocal laser endomicroscopy] [77,78] . In a study by Kiesslich et al [79] endomicroscopy or colonoscopy were performed in 153 UC patients.…”

Section: Endoscopic Surveillance In Ibdmentioning

confidence: 99%

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Lakatos¹,

Lakatos²

2008

WJG

373

245

View full text Add to dashboard Cite

Since the first report of an inflammatory bowel disease (IBD) case associated with colorectal cancer (CRC) by Crohn and Rosenberg [1] , significant efforts have been made to elucidate this presumed association. Nowadays, the association between IBD and the increased risk for CRC is widely accepted. Although CRC, complicating ulcerative colitis and Crohn's disease, accounts only for 1%-2% of all cases of CRC in the general population, it is considered a serious complication of the disease and accounts for approximately 10%-15% of all deaths in IBD patients [2] . The age at diagnosis of CRC associated with IBD is 15-20 years earlier compared to sporadic cancers. In the meta-analysis by Eaden et al [3] , the average age at diagnosis was 43.2 years. Similarly, in a recent publication from Eastern Europe [4] , it was found to be 50.9 years, 10-15 years younger compared to sporadic CRC cases from the same area (62.2 years) [5] . According to US [6] and Canadian [7] publications, almost two-thirds of the affected patients were males, yet results are conflicting [4,8] . In addition, the frequency of multiple CRCs is higher than in patients with sporadic CRC [9] .The increased risk of CRC in UC is almost a universal finding [3,[10][11][12][13] , yet the extent of this risk varies considerably with differences in study design and geographic area. The initial reports were published by tertiary gastroenterology centers, thus the high risk detected might have been a consequence of referral bias and overinterpretation due to the high percentage of extensive and chronically active cases in these cohorts. Results of population-based studies are more reliable; however, several geographical and ethnic differences have been noted.The report of the meta-analysis by Eaden et al [3] in 2001 was one of several milestones in this subject. The incidence of UC-associated CRC was estimated based on 116 articles involving 54 478 patients in whom 1698 CRC cases were detected. This was a mixture of referral center-based, hospital-based, and population-based studies of variable methodological qualities and levels of detail. The reported incidence was higher in the US AbstractThe risk of colorectal cancer for any patient with ulcerative colitis is known to be elevated, and is estimated to be 2% after 10 years, 8% after 20 years and 18% after 30 years of disease. Risk factors for cancer include extent and duration of ulcerative colitis, primary sclerosing cholangitis, a family history of sporadic colorectal cancer, severity of histologic bowel inflammation, and in some studies, young age at onset of colitis. In this review, the authors discuss recent epidemiological trends and causes for the observed changes. Population-based studies published within the past 5 years suggest that this risk has decreased over time, despite the low frequency of colectomies. The crude annual incidence rate of colorectal cancer in ulcerative colitis ranges from approximately 0.06% to 0.16% with a relative risk of 1.0-2.75. The exact mechanism for this chang...

show abstract

Section: Endoscopic Surveillance In Ibdmentioning

confidence: 99%

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Lakatos¹,

Lakatos²

2008

WJG

373

245

View full text Add to dashboard Cite

show abstract

“…For instance, narrow-band imaging (NBI), autofl uorescence, endocytoscopy, and endomicroscopy will compete in the fi eld of early cancer diagnosis [23]. Narrow-band imaging enables the analysis of vessel architecture and provides similar image quality as compared to chromoendoscopy using an optical fi lter.…”

Section: Differential Diagnosismentioning

confidence: 99%

Distinction of high-grade intraepithelial neoplasia and invasive Barrett's adenocarcinoma

Kießlich

2006

Esophagus

View full text Add to dashboard Cite

Grading of intraepithelial neoplasia and diagnosis of mucosal carcinoma in Barrett's esophagus provokes controversy when discussed because there is wide interobserver and intraobserver variation of such diagnoses. With new endoscopic techniques, it might become easier to target biopsies to the most relevant structural changes to achieve more-precise diagnoses. Nevertheless, the distinction between high-grade intraepithelial neoplasia and mucosal carcinoma is almost without clinical relevance because both lesions need to be removed endoscopically if it is proven that they are defi nitively limited to the mucosal level. Studies on the "natural course" of high-grade intraepithelial neoplasia show that overdiagnoses and underdiagnoses occur at receipt of the surgical specimen. Our knowledge of diagnostic criteria should be increased.

show abstract

“…La plupart des nouvelles techniques de visualisation de la muqueuse digestive, certaines qualifiées de « biopsies virtuelles », sont des candidates potentielles pour la surveillance des MICI : tomographie par cohérence optique, l'endoscopie en bande étroite (NBI), l'endomicroscopie confocale, la fluorescence... [9]. Certaines nécessitent un matériel spécifique et coûteux et aucune d'entre elles n'a jusqu'à présent fait la preuve de son utilité dans cette indication.…”

Section: Abstract: Cancer -Ulcerative Colitis -Screeningendoscopyunclassified

Chromoendoscopy and ulcerative colitis

Bulois¹

2007

Côlon Rectum

View full text Add to dashboard Cite

Situation du problème et objectifs : Le diagnostic précoce de dysplasie et d'adénocarcinome est particulièrement important dans la prise en charge de la rectocolite hémorragique (RCH). Nous rapportons une étude contrôlée et randomisée évaluant l'intérêt de la chromoendoscopie (CE) dans le dépistage précoce de la dysplasie et du cancer au cours de la RCH.Méthodes : Deux cent soixante-trois patients porteurs d'une RCH depuis au moins huit ans étaient évalués pour l'inclusion. Cent soixante-cinq d'entre eux étaient inclus et randomisés en deux groupes égaux pour bénéficier d'une coloscopie conventionnelle ou d'une CE au bleu de méthylène à 0,1 %. Cinq biopsies tous les 10 cm étaient prélevées du rectum au caecum. Les anomalies focales de la muqueuse étaient évaluées en fonction d'une version modifiée de la classification des pit pattern.Re´sultats : Dans le groupe CE, on observait une meilleure corrélation entre l'évaluation endoscopique et histologique du degré (89 vs 52 % ; p < 0,0001) et de l'extension de l'inflammation colique que dans le groupe coloscopie conventionnelle. Un nombre plus important de biopsies ciblées était possible. Le nombre de dysplasies détectées était significativement plus important dans le groupe CE que dans le groupe coloscopie conventionnelle (32 vs 10 ; p = 0,003). La spécificité et la sensibilité de la classification modifiée des pit pattern pour la différen-ciation entre lésions néoplasiques et non néoplasiques étaient de 93 %.Conclusions : Dans cette étude prospective et randomisée, la CE permettait un diagnostic plus précis de l'extension et de la sévérité de l'activité inflammatoire au cours de la RCH que la coloscopie conventionnelle. De plus, la CE au bleu de méthylène est un nouvel outil diagnostique dans la détection précoce de la dysplasie et de l'adéno-carcinome chez les patients porteurs de RCH. Ces données ont des implications importantes dans l'indication des traitements médicaux et chirurgicaux. Mots clés : Cancer -Rectocolite hémorragique -Dépistage -EndoscopieChromoendoscopy and ulcerative colitis Abstract: Background and aims: Timely diagnosis of intraepithelial neoplasias (IN) and colitis-associated colon carcinomas (CRC) is crucially important in the treatment of ulcerative colitis (UC). We performed a randomized, controlled trial to test whether chromoendoscopy (CE) can facilitate early detection of IN and CRC in ulcerative colitisMethods: A total of 263 patients with long-standing UC (8 years or more) were screened for inclusion in the study, 165 of whom were randomized at a 1:1 ratio to undergo conventional colonoscopy or colonoscopy with CE using 0.1% methylene blue. Five mucosal biopsy specimens were taken every 10 cm between the rectum and caecum. Circumscript lesions in the colon were evaluated according to a modified pit pattern classification.Results: In the CE group, there was a significantly higher correlation between the endoscopic assessment of degree (P = 0.0002) and extent (89 vs 52%; P < 0.0001) of colonic inflammation and the histopathologic findings...

show abstract

Colonoscopy, Tumors, and Inflammatory Bowel Disease - New Diagnostic Methods

Cited by 46 publications

References 31 publications

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Risk for colorectal cancer in ulcerative colitis: Changes, causes and management strategies

Distinction of high-grade intraepithelial neoplasia and invasive Barrett's adenocarcinoma

Chromoendoscopy and ulcerative colitis

Contact Info

Product

Resources

About