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Dysplasia in inflammatory bowel disease

Fernando Velayos, Priya Kathpalia, Emily Finlayson
This review chronicles the evolution of dysplasia detection and management in IBD since 1925, the year the first case report of colitis-related colorectal cancer was published. We have grouped advances in colorectal cancer research, endoscopic techniques, surgery, and technology into 4 unequally timed eras, before colonoscopy, early era of colonoscopy, new century, and 2017 and beyond. We conclude that colorectal cancer prevention and dysplasia management for patients with IBD has changed over these periods, from somewhat hopeless to hopeful...
October 17, 2016: Gastroenterology
Parambir S Dulai, William J Sandborn, Samir Gupta
Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory bowel diseases (IBD) characterized by recurrent episodes of mucosal inflammation. This chronic mucosal inflammation has several potential consequences, one of which is the occurrence of colitis associated colorectal cancer (CRC). Over the past decade our understanding of the epidemiology, pathophysiology, and overall approach to diagnosing and managing colitis associated CRC, has grown considerably. In the current review article, we outline these advancements and highlight areas in need of further research...
September 27, 2016: Cancer Prevention Research
Marjorie M Walker, Angela K Harris, Georgia C Edwards, Nicholas J Talley
BACKGROUND: Colonoscopic biopsies are taken to make a diagnosis of inflammation, dysplasia or malignancy, to assess treatment success and to monitor patients' progression. OBJECTIVE: This aim of this article is to provide a guide to understanding histology reports sent to the general practitioner (GP) from the colonoscopy and anatomical pathology departments for the diagnosis of increasingly prevalent gastrointestinal (GI) diseases. DISCUSSION: Many diseases in the lower GI tract are increasing in prevalence and new diseases are emerging that require biopsy for diagnosis...
June 2016: Australian Family Physician
J R Ten Hove, E Mooiweer, E Dekker, A E van der Meulen-de Jong, G J A Offerhaus, C Y Ponsioen, P D Siersema, B Oldenburg
BACKGROUND & AIMS: When dysplastic lesions are encountered during surveillance colonoscopy of patients with inflammatory bowel diseases (IBD), guidelines recommend collection of additional biopsies from the surrounding mucosa, to ensure the lesion has been adequately circumscribed. We aimed to determine the rate of dysplasia in mucosa biopsies collected from tissues surrounding dysplastic lesions during IBD surveillance. METHODS: In a retrospective study, we collected endoscopy and pathology reports from 1065 patients undergoing colonoscopic surveillance for IBD, from 2000 through 2015, at 3 centers in the Netherlands...
September 6, 2016: Clinical Gastroenterology and Hepatology
Cristiana Popp, Luciana Nichita, Theodor Voiosu, Alexandra Bastian, Mirela Cioplea, Gianina Micu, Gabriel Pop, Liana Sticlaru, Andreea Bengus, Andrei Voiosu, Radu Bogdan Mateescu
Ulcerative colitis (UC) is a chronic, relapsing inflammatory bowel disease that slightly increases the risk of colorectal cancer in patients with long-standing extended disease. Overexpression of p53 and p21 in colonic epithelia is usually detected in UC patients when no dysplasia is histologically seen and it is used by pathologists as a discriminator between regenerative changes and intraepithelial neoplasia, as well as a tissue biomarker useful to predict the risk of evolution toward malignancy. We present a one-year prospective observational study including a cohort of 45 patients with UC; p53 and p21 were evaluated in epithelial cells...
2016: Disease Markers
Ehsen B Brahim, Ali Mrabet, Raja Jouini, Wafa Koubaa, Rimel B Sidhom, Hela Elloumi, Aschraf Chadli
BACKGROUND AND STUDY AIMS: Development of cancer is the most significant complication in inflammatory bowel disease (IBD). Distinguishing true dysplasia from reactive atypia in polyps is difficult, leading sometimes to the unsatisfactory diagnosis of "indefinite for dysplasia". Therefore, there is a need for the development of markers that can help improve diagnosis. We evaluated the diagnostic value of the expression of AMACR, Ki67 and p53 by immunohistochemistry in the diagnosis of dysplasia in polyps developed on IBD...
September 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
Aldona Dlugosz, Ammar Mohkles Barakat, Niklas K Björkström, Åke Öst, Annika Bergquist
BACKGROUND AND STUDY AIMS: Primary sclerosing cholangitis associated inflammatory bowel disease (PSC-IBD) is characterized by a high risk of colorectal dysplasia. Surveillance colonoscopies with random biopsies have doubtful power for dysplasia detection. Our aim was to prospectively investigate the feasibility and efficacy of pCLE in surveillance colonoscopies in patients with PSC-IBD. PATIENTS AND METHODS: Sixty-nine patients with PSC-IBD underwent colonoscopy in 2 steps...
August 2016: Endoscopy International Open
Whitney E Jackson, Jean-Paul Achkar, Carole Macaron, Lili Lee, Xiuli Liu, Rish K Pai, Rocio Lopez, Carol A Burke, Daniela S Allende
BACKGROUND: The significance of serrated lesions in inflammatory bowel disease (IBD) remains unclear. We aim to characterize synchronous and metachronous lesions in IBD patients with an index serrated polyp and compare them to sporadic subjects with SSP. METHODS: Serrated lesions in patients with IBD were identified from a pathology database and, after review, were reclassified as hyperplastic (HP), sessile serrated (SSPs), or serrated polyps unclassifiable (SPU)...
September 2016: Inflammatory Bowel Diseases
Soo Hyun Shin, Deepak K Kadayakkara, Jeff W M Bulte
Purpose To investigate whether the magnitude of in vivo fluorine 19 ((19)F) magnetic resonance (MR) imaging signal is associated with subsequent development of colitis-associated dysplasia after in situ fluorination of inflammatory macrophages in a mouse model of inflammatory bowel disease (IBD). Materials and Methods Experiments were approved by the institutional animal care and use committee. Mice in the experimental group (n = 10) were administered azoxymethane and dextran sulfate sodium to induce colitis-associated dysplasia...
July 19, 2016: Radiology
Sawan Bopanna, Maitreyee Roy, Prasenjit Das, S Dattagupta, V Sreenivas, V Pratap Mouli, Saurabh Kedia, Rajan Dhingra, Rajesh Pradhan, N Suraj Kumar, Dawesh P Yadav, Govind Makharia, Vineet Ahuja
BACKGROUND/AIMS: Recent data suggest that the incidence of ulcerative colitis (UC) related colorectal cancer (CRC) in India is similar to that of West. The optimum method for surveillance is still a debate. Surveillance with random biopsies has been the standard of care, but is a tedious process. We therefore undertook this study to assess the yield of random biopsy in dysplasia surveillance. METHODS: Between March 2014 and July 2015, patients of UC attending the Inflammatory Bowel Disease clinic at the All India Institute of Medical Sciences with high risk factors for CRC like duration of disease >15 years and pancolitis, family history of CRC, primary sclerosing cholangitis underwent surveillance colonoscopy for dysplasia...
July 2016: Intestinal Research
Emre Gorgun, Cigdem Benlice, James M Church
BACKGROUND: There is a continuing debate on the best approach for endoscopically benign large polyps that are unsuitable for conventional endoscopic resection. This study aimed to estimate the cancer risk in patients with endoscopically benign unresectable colonic polyps referred for surgery. STUDY DESIGN: We assessed patients with an endoscopic diagnosis of benign adenoma deemed not amenable to endoscopic removal, who underwent colectomy between 1997 and 2012. Patients with preoperative diagnoses of cancer, inherited polyposis syndrome, inflammatory bowel disease, and synchronous pathology requiring surgery were excluded...
September 2016: Journal of the American College of Surgeons
Ashley J Snider, Agnieszka B Bialkowska, Amr M Ghaleb, Vincent W Yang, Lina M Obeid, Yusuf A Hannun
Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), significantly increases the risk for development of colorectal cancer. Specifically, dysplasia and cancer associated with IBD (colitis-associated cancer or CAC) develop as a result of repeated cycles of injury and healing in the intestinal epithelium. Animal models are utilized to examine the mechanisms of CAC, the role of epithelial and immune cells in this process, as well as the development of novel therapeutic targets...
2016: Methods in Molecular Biology
Daniela Štefănescu, S P Pereira, M M Filip, A Săftoiu, S Cazacu
BACKGROUND: Crohn's disease and ulcerative colitis are inflammatory bowel diseases (IBD) associated with colorectal cancer risk in long-standing diseases. In order to assess the colonic mucosa and to discover dysplastic or neoplastic lesions, advanced endoscopic techniques are needed. Such techniques are detailed in this review: chromoendoscopy, autofluorescence imaging (AFI), narrow band imaging (NBI), i-SCAN, Fujinon Intelligent Color Enhancement (FICE) and confocal laser endomicroscopy (CLE)...
January 2016: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Anthony Lopez, Benjamin Collet-Fenetrier, Arthur Belle, Laurent Peyrin-Biroulet
OBJECTIVE: To investigate knowledge and fear of colorectal cancer (CRC) risk in inflammatory bowel disease (IBD) patients. METHODS: A 12-item self-administered questionnaire, developed after a careful literature review, was administered to all consecutive IBD patients treated with infliximab who were followed up at Nancy University Hospital (Vandoeuvre-lès-Nancy, France) between February and May 2012. RESULTS: Altogether 100 patients including 72 with Crohn's disease (CD) were included...
June 2016: Journal of Digestive Diseases
David H Johnson, William R Taylor, Mohammed M Aboelsoud, Patrick H Foote, Tracy C Yab, Xiaoming Cao, Thomas C Smyrk, Edward V Loftus, Douglas W Mahoney, David A Ahlquist, John B Kisiel
BACKGROUND: Stool DNA testing in patients with inflammatory bowel disease (IBD) may detect colorectal cancer and advanced precancers with high sensitivity; less is known about the presence of DNA markers in small IBD lesions, their association with metachronous neoplasia, or contribution to stool test positivity. METHODS: At a single center in 2 blinded phases, we assayed methylated bone morphogenic protein 3, methylated N-Myc downstream-regulated gene 4, and mutant KRAS in DNA extracted from paraffin-embedded benign lesions, and matched control tissues of patients with IBD, who were followed for subsequent colorectal dysplasia...
July 2016: Inflammatory Bowel Diseases
Tonya Kaltenbach, Kenneth R McQuaid, Roy Soetikno, Loren Laine
No abstract text is available yet for this article.
May 2016: Gastrointestinal Endoscopy
Tetsushi Kinugasa, Yoshito Akagi
Surgical therapy for ulcerative colitis (UC) depends on the medical therapy administered for the patient's condition. UC is a benign disease. However, it has been reported that the rare cases of cancer in UC patients are increasing, and such cases have a worse prognosis. Recently, surgical therapy has greatly changed, there has been quite an increase in the number of UC patients with high-grade dysplasia and/or cancer. These lesions are known as colitis-associated cancer (CAC). The relationship between inflammation and tumorigenesis is well-established, and in the last decade, a great deal of supporting evidence has been obtained from genetic, pharmacological, and epidemiological studies...
April 15, 2016: World Journal of Gastrointestinal Oncology
Elena Talero, Antonio Alcaide, Javier Ávila-Román, Sofía García-Mauriño, Débora Vendramini-Costa, Virginia Motilva
BACKGROUND: Interleukin-10-deficient (IL-10 (-/-)) mice spontaneously develop chronic colitis and adenocarcinoma through the dysplasia sequence. Autophagy malfunction is associated to inflammatory bowel disease (IBD) and colorectal cancer (CRC) pathogenesis. Autophagy is regulated by silent information regulator-1 (SIRT1), a NAD+-dependent histone deacetylase. Our aim was to investigate the expression changes of SIRT1-AMPK-autophagy pathway in the progression from chronic colitis to CRC...
June 2016: International Immunopharmacology
Alessandro Fugazza, Federica Gaiani, Maria Clotilde Carra, Francesco Brunetti, Michaël Lévy, Iradj Sobhani, Daniel Azoulay, Fausto Catena, Gian Luigi de'Angelis, Nicola de'Angelis
Confocal laser endomicroscopy (CLE) is an endoscopic-assisted technique developed to obtain histopathological diagnoses of gastrointestinal and pancreatobiliary diseases in real time. The objective of this systematic review is to analyze the current literature on CLE and to evaluate the applicability and diagnostic yield of CLE in patients with gastrointestinal and pancreatobiliary diseases. A literature search was performed on MEDLINE, EMBASE, Scopus, and Cochrane Oral Health Group Specialized Register, using pertinent keywords without time limitations...
2016: BioMed Research International
Han-Han Zheng, Xue-Liang Jiang
Ulcerative colitis (UC) patients with concomitant primary sclerosing cholangitis (PSC) carry an increased risk of colorectal neoplasia (dysplasia and cancer), whereas the association between PSC and the development of colorectal neoplasia in Crohn's disease (CD) is controversial. A meta-analysis was carried out to compare the risk of this neoplasia in patients with inflammatory bowel disease (IBD) with and without PSC. A systematic research of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials was performed to identify studies that compared the risk of colorectal neoplasia (dysplasia and cancer) in patients with IBD with and without PSC...
April 2016: European Journal of Gastroenterology & Hepatology
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