Surveillance colonoscopy in patients with inflammatory bowel disease: comparison of random biopsy vs. targeted biopsy protocols

Günther, Ute; Kusch, Dajana; Heller, Frank; Bürgel, Nataly; Leonhardt, Silke; Daum, S; Siegmund, Britta; Loddenkemper, Christoph; Grünbaum, Maria; Buhr, H. J.; Schulzke, Jörg–Dieter; Zeitz, Martin; Bojarski, Christian

doi:10.1007/s00384-011-1130-y

Cited by 86 publications

(53 citation statements)

References 28 publications

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“…Furthermore, if only CLE-suspected neoplastic lesions had been biopsied, the mean number of biopsies would have dropped to 0.78 per patient. The value of combining CE to CLE for the detection of neoplasia was confirmed in two subsequent studies [38,39]. Therefore, this approach has the potential for a more efficient detection of colitis-associated neoplasia with a considerable cost saving for the pathologist.…”

Section: Advanced Endoscopic Imaging For Ulcerative Colitismentioning

confidence: 69%

Advanced endoscopic imaging for dysplasia surveillance in ulcerative colitis

Bessissow

Bisschops

2013

Expert Review of Gastroenterology & Hepatology

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Section: Advanced Endoscopic Imaging For Ulcerative Colitismentioning

confidence: 69%

Advanced endoscopic imaging for dysplasia surveillance in ulcerative colitis

Bessissow

Bisschops

2013

Expert Review of Gastroenterology & Hepatology

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“…Our present study showed that 7 of the 11 dysplasia/cancer lesions (63.6%) were representative of the neoplastic capillary pattern. Together with the results from recent randomized trials demonstrating that NbI was a reasonable alternative to CE (34)(35)(36)(37), NbI is one of the available modalities to distinguish neoplastic lesion associated with UC.…”

Section: Discussionmentioning

confidence: 89%

Advanced endoscopic features of ulcerative colitis-associated neoplasias: Quantification of autofluorescence imaging

Yoshioka

Mitsuyama

Takedatsu

et al. 2015

International Journal of Oncology

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Abstract. Ulcerative colitis (UC) patients are well known to carry a higher risk of developing colorectal dysplasia/cancer. However, it is hard to detect the lesion in the early phase during colonoscopy. This pilot study was conducted to analyze the endoscopic characteristics of neoplastic lesions associated with UC using advanced imaging techniques. This is a retrospective analysis of 15 colorectal neoplastic lesion obtained from 11 UC patients during remission who underwent whitelight-and advanced endoscopic imaging techniques, including chromoendoscopy, narrow-band imaging and autofluorescence imaging (AFI), and were treated with surgery. These lesions were analyzed for histology, location, size, shape, color and endoscopic features. The green/red ratio was also assessed to quantify the AFI intensity. All 11 patients had extensive colitis with the median disease duration of 14.0 years. A total of 15 lesions, consisting of 8 high-grade dysplasia and 7 cancer, was mostly located in the distal colon (86.7%, 13/15) with the mean size of 8.6 mm. The shape was protruding in 46.7% (7/15), flat elevated in 40.0% (6/15) and flat in 13.3% (2/15) and the color was red in 60.0% (9/15), same colored in 33.3% (5/15) and discolored in 6.7% (1/15). The lesion predominantly showed Kudo's neoplastic pit pattern in 86.7% (13/15; 5 type IIIL, 7 type IV and 1 type VI) on chromoendoscopy and Sano's neoplastic capillary pattern (type IIIa) in 63.6% (7/11) on narrow-band imaging, but were colored purple as neoplastic lesions in only 37.5% (3/8) on AFI. Of note, the AFI green/red ratio was significantly lower in the neoplastic lesions than UC-involved areas (p=0.00014) and UC-uninvolved areas (p=0.00651) irrespective of the lesion's size and histological type. In conclusion, endoscopic analysis based on advanced imaging, in particular AFI quantitation, may be helpful to detect early stage neoplastic lesions in long standing UC. Large-scale, prospective studies are needed.

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“…However, when looking at histological evaluation of the inflammation intensity in biopsy samples, it is more evident that the applied probiotics ameliorated inflammatory reactions in patients in remission but not in those with acute UC. This discrepancy may be explained by the fact that a decrease of inflammatory changes observed under the microscope usually precedes clinical [12]. Recently, Rowland and his colleagues have stated in their overview on probiotics in UC, that the evidence for the role of some probiotic strains in prolonging remission in patients with UC is promising and deserves further investigation.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, several genes and genetic loci that contribute to susceptibility to IBD have been identified [1]. Some, such as activation of G protein Ga 12 (encoded by GNA12), which leads to destabilization of cell junctions, or mucus layer defects related to Muc2 mutation, impair epithelial barrier function and enable direct interactions of the gut commensal microbiota with intestinal epithelia and dendritic cells [2]. There is increasing evidence showing that human gut microbiota play a role in the development and maintenance of UC [3].…”

Section: Introductionmentioning

confidence: 99%

Influence of Lactobacillus and Bifidobacterium Combination on the Gut Microbiota, Clinical Course, and Local Gut Inflammation in Patients with Ulcerative Colitis: A Preliminary, Single-center, Open-label Study

Zurek¹,

Wcisło²,

Mach³

et al. 2017

J Prob Health

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Background: Ulcerative colitis (UC) is one of the chronic, relapsing, inflammatory disorders of the gut and is characterized by inflammation limited in most cases to the colon. Since gut microbiota play a critical role in the development and perpetuation of intestinal inflammation, the addition of probiotics to this complex system may exert a positive influence on gut inflammatory reactions. Methods:A single center, open-label, intention-to-treat study involving patients with moderate-to-severe UC was performed to check whether a probiotic mixture containing Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium longum given together with a standard treatment could decrease clinical and histopathology indexes for UC evaluation. Results:The mixture given once a day for at least 2 months together with mesalazine and ciprofloxacin to patients in the acute phase of UC significantly reduced their Mayo Clinic Index values. Moreover, numbers of Lactobacilli isolated from patients feces were significantly increased, while those of Gram-negative rods decreased. The mixture given together with mesalazine to patients with UC in remission also caused a decrease of their clinical scores, but a more prominent and significant decrease of the histopathological index values in biopsy samples was observed. Conclusions:Supplementation of standard therapy with the probiotic mixture used in this study was efficacious in inducing and maintaining remission in UC, and this effect was related to modulation of dysbiosis in the gut microbiota. analyzed randomized clinical trials and found that selected probiotics were efficacious in inducing and maintaining remission in UC [8]. Another review reached nearly the same conclusions on the efficacy of probiotics in UC [9]. Influence of Lactobacillus and Bifidobacterium Combination on the Gut• The aim of this study was to investigate in a single center, openlabel, intention-to-treat study involving patients with moderateto-severe UC whether a probiotic mixture containing Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium longum given together with standard therapy could decrease clinical and histopathology indexes for UC. Materials and Methods PatientsAltogether, 51 patients (21 with UC in remission and 30 in the active phase of UC) of both sexes and between 18 and 72 years of age who were being treated in the Jagiellonian University Medical College Clinic of Gastroenterology in Cracow, Poland were enrolled. The study was conducted from 2008 to 2011 and was approved by the Jagiellonian University independent ethics committee (No KBET/5/B/2007). Written informed consent was obtained from all patients before enrollment.Inclusion criteria included an existing diagnosis of UC based on disease history, colonoscopy results, and histopathologic evaluation of biopsies from the colonic mucosa. The patients were not treated with antibiotics for three months before enrollment. Exclusion criteria were: diabetes, autoimmune diseases, severe systemic diseases, alcoho...

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Surveillance colonoscopy in patients with inflammatory bowel disease: comparison of random biopsy vs. targeted biopsy protocols

Abstract: Targeted biopsy protocols guided by either chromoendoscopy or CEM led to higher detection rates of IEN and are thus mandatory for surveillance colonoscopies in patients with long-standing UC. Random biopsy protocols should be replaced by chromoendoscopy-guided protocols.

Cited by 86 publications

References 28 publications

Advanced endoscopic imaging for dysplasia surveillance in ulcerative colitis

Advanced endoscopic imaging for dysplasia surveillance in ulcerative colitis

Advanced endoscopic features of ulcerative colitis-associated neoplasias: Quantification of autofluorescence imaging

Influence of Lactobacillus and Bifidobacterium Combination on the Gut Microbiota, Clinical Course, and Local Gut Inflammation in Patients with Ulcerative Colitis: A Preliminary, Single-center, Open-label Study

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