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Dysplasia in ulcerative colitis

Jimmy K Limdi, Francis A Farraye
PURPOSE OF REVIEW: Patients with long-standing ulcerative colitis have an increased risk for the development of colorectal cancer (CRC). Colitis-related dysplasia appears to confer the greatest risk. Colonoscopic surveillance to detect dysplasia has been advocated by gastrointestinal societies. The aim of surveillance is the reduction of mortality and morbidity of CRC through detection and resection of dysplasia or detecting CRC at an earlier and potentially curable stage. Traditional surveillance has relied on mucosal assessment with targeted biopsy of visible lesions and random biopsy sampling on the premise that dysplasia was not visible at endoscopy...
March 7, 2018: Current Gastroenterology Reports
Saeed Azizi, Hussein Al-Rubaye, Mohammed Adil Turki, Muhammad R Sameem Siddiqui, Arun P Shanmuganandan, Bushra Ehsanullah, Ranjeet Brar, Al-Mutaz Abulafi
BACKGROUND: Endoscopic examinations are a vital diagnostic tool for dysplasia. Establishing the precision of different modes of examination is essential due to the disparate pick-up rates of dysplasia. OBJECTIVE: The aim of this article was to establish the pick-up rates of dysplastic or cancerous lesions using white light endoscopy (WLE) and random/targeted biopsies, or chromoendoscopy (CE), in patients with ulcerative colitis (UC) without primary sclerosing (PSC) or Crohn's disease (CD)...
February 17, 2018: International Journal of Surgery
Paula M De Angelis, Aasa R Schjølberg, Juliana B Hughes, Henrik S Huitfeldt, Solveig Norheim Andersen, Anne Carine Østvold
Background: The colon and rectum are continuously exposed to oxidative stress that generates reactive oxygen species, which are a major cause of DNA double-strand breaks (DSB). Furthermore, chronic inflammatory diseases such as ulcerative colitis (UC) are characterized by an excess of reactive nitrogen species that can also lead to DNA double-strand breakage and genomic instability. We investigated the expression of the nuclear casein kinase and cyclin-dependent kinase substrate 1 (NUCKS1) protein in UC and sporadic colorectal cancer (CRC) due to its involvement in both DNA double-strand break repair and inflammatory signaling...
February 15, 2018: Inflammatory Bowel Diseases
Hajar Khazraei, Alimohammad Bananzadeh, Seyed Vahid Hosseini
Background: Ulcerative colitis (UC) is an idiopathic inflammatory disorder. Currently, the final treatment is colectomy. The aim of this study was to investigate the outcomes of proctocolectomy in patients that used a high dose of prednisolone. Materials and Methods: Seventy-five patients presenting for surgical management of histopathologically proven UC. All patients were offered total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA). Patients were divided into two groups: low dose of steroids (Group A) and high dose of steroid (Group B) consumers...
2018: Advanced Biomedical Research
I O Gordon, N Agrawal, E Willis, J R Goldblum, R Lopez, D Allende, X Liu, D Y Patil, L Yerian, F El-Khider, C Fiocchi, F Rieder
BACKGROUND: Fibrosis in ulcerative colitis has remained largely unexplored despite its clinical implications. AIMS: This cross-sectional study was aimed at characterising the presence, anatomical location and degree of ulcerative colitis-associated fibrosis and its possible link to clinical parameters. METHODS: Seven hundred and six individual tissue cross-sections derived every 10 cm along the length of 89 consecutive Ulcerative colitis colectomy specimens were examined and compared to Crohn's disease colitis, diverticular disease and uninvolved areas from colorectal cancer patients...
February 6, 2018: Alimentary Pharmacology & Therapeutics
Carlos A Rubio, Giovanni DE Petris, Giacomo Puppa
BACKGROUND: In ulcerative colitis (UC), the majority of colorectal carcinomas (CRC) arise in the vast colorectal mucosal domain built with mucus-producing goblet cells and columnar cells. Conversely, CRC in UC rarely evolve in the tiny, spotty gut-associated lymphoid tissue (GALT) mucosal domain. Here we review the four reported cases of colonic carcinoma developing in GALT mucosa in UC, searching for possible precursor lesions connected with the evolution of these tumours. MATERIALS AND METHODS: The clinical history, age, gender, endoscopic descriptions, and the pathology (localization, gross and histological descriptions of the luminal surface) of the four UC-GALT carcinomas reported in the literature were reviewed...
February 2018: Anticancer Research
Elena Bolzacchini, Claudio Chini, Claudio Camillo Cortelezzi, Ilaria Vallini, Graziella Pinotti, Stefano La Rosa, Silvia Uccella
A 37-year-old male with long-standing and extensive ulcerative pancolitis developed a rapidly lethal poorly differentiated neuroendocrine carcinoma (NEC) in the sigmoid colon. Prior biopsies obtained from multiple sites of the colon during endoscopic surveillance showed minimal inflammatory changes and no sign of dysplasia. Patients with inflammatory bowel disease (IBD) are at increased risk of colorectal malignancies, and adenocarcinoma is the most common type of colorectal neoplasm associated with ulcerative colitis and Crohn's disease, but other types of epithelial and nonepithelial tumors have also been described in IBD...
January 1, 2018: International Journal of Surgical Pathology
Jie Han, Dakota Jackson, Janette Holm, Kevin Turner, Paula Ashcraft, Xuan Wang, Beth Cook, Erland Arning, Robert M Genta, K Venuprasad, Rhonda F Souza, Lawrence Sweetman, Arianne L Theiss
d-2-hydroxyglutarate (D2HG) is produced in the tricarboxylic acid cycle and is quickly converted to α-ketoglutarate by d-2-hydroxyglutarate dehydrogenase (D2HGDH). In a mouse model of colitis-associated colon cancer (CAC), urine level of D2HG during colitis correlates positively with subsequent polyp counts and severity of dysplasia. The i.p. injection of D2HG results in delayed recovery from colitis and severe tumorigenesis. The colonic expression of D2HGDH is decreased in ulcerative colitis (UC) patients at baseline who progress to cancer...
January 16, 2018: Proceedings of the National Academy of Sciences of the United States of America
M J Lu, X Y Qiu, X Q Mao, X T Li, H J Zhang
BACKGROUND: Patients with inflammatory bowel disease (IBD) have a high risk of developing colorectal neoplasia. AIM: To investigate whether thiopurines can decrease the risk of developing colorectal neoplasia in patients with ulcerative colitis (UC) or Crohn's disease (CD). METHODS: We conducted a meta-analysis of 24 observational studies involving 76,999 participants to evaluate the risks of developing colorectal neoplasia in IBD patients receiving thiopurine treatment...
February 2018: Alimentary Pharmacology & Therapeutics
Satoshi Kinoshita, Toshio Uraoka, Toshihiro Nishizawa, Makoto Naganuma, Yasushi Iwao, Yasutoshi Ochiai, Ai Fujimoto, Osamu Goto, Masayuki Shimoda, Haruhiko Ogata, Takanori Kanai, Naohisa Yahagi
BACKGROUND AND AIM: Patients with ulcerative colitis have an increased risk of colorectal dysplasia. Endoscopic submucosal dissection (ESD) for the neoplastic lesions in ulcerative colitis remains controversial. The aim of this study was to clarify the role of ESD in treatment strategy for ulcerative colitis. METHODS: We retrospectively investigated 25 patients with ulcerative colitis in clinical remission who underwent colorectal ESD at two referral centers. We analyzed short-term and long-term outcomes...
November 6, 2017: Gastrointestinal Endoscopy
Ross D Cranston, Miguel Regueiro, Jana Hashash, Jonathan R Baker, Nicola Richardson-Harman, Laura Janocko, Ian McGowan
BACKGROUND: Defective cell-mediated immunity increases the risk of human papillomavirus-associated anal dysplasia and cancer. There is limited information on anal canal disease in patients with IBD. OBJECTIVE: The purpose of this study was to assess anal/vaginal human papillomavirus and anal dysplasia prevalence in patients with IBD. DESIGN: Patients had an anal examination before routine colonoscopy. SETTINGS: The study was conducted at a tertiary IBD referral center...
December 2017: Diseases of the Colon and Rectum
Xiaohong Lu, Yuanjie Yu, Shiyun Tan
BACKGROUND: Tumor suppressor gene p53 expression has been reported in patients with ulcerative colitis (UC). However, the correlation between p53 expression and UC remains controversial. The aim of this meta-analysis was to investigate the association between p53 expression and different pathological types of UC. METHODS: Publications were searched in the PubMed, Embase, EBSCO, Wangfang, and CNKI databases. The overall odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs) were summarized in this study...
October 25, 2017: BMC Gastroenterology
Toufic Saber, Khalil Bedran, Fatima Ghandour, Mansour El Khoury, Roula Bou Khalil, Said Farhat
BACKGROUND AND AIMS: Inflammatory bowel diseases (IBDs) and colorectal cancer have an increased impact on the Lebanese population's morbidity and mortality. This study evaluated the situation of IBD and colorectal cancer at a tertiary hospital centre in Lebanon. METHODS: 1007 patients underwent colonoscopy over a period of 12 months by qualified physicians. 91 patients were excluded from the study. Biopsy results were divided into normal versus abnormal colonic tissue...
2017: BMJ Open Gastroenterology
Raf Bisschops, Talat Bessissow, Evelien Dekker, James E East, Adolfo Para-Blanco, Krish Ragunath, Pradeep Bhandari, Matt Rutter, Erik Schoon, Ana Wilson, Jestinah Mahachie John, Kristel Van Steen, Filip Baert, Marc Ferrante
BACKGROUND AND AIMS: Patients with longstanding ulcerative colitis (UC) are at increased risk of developing colorectal neoplasia. Chromoendoscopy (CE) increases detection of lesions, and Kudo pit pattern classification I and II have been suggested to be predictive of benign polyps in UC. Little is known on the use of this classification in nonmagnified high-definition (HD) (virtual) CE and narrow-band Imaging (NBI) or on the interobserver agreement. The aim of this pilot study was to assess the diagnostic accuracy and the interobserver agreement of the Kudo pit pattern classification in UC patients undergoing surveillance with methylene blue CE or NBI in a multicenter study...
December 2017: Gastrointestinal Endoscopy
Ofir Har-Noy, Lior Katz, Tomer Avni, Robert Battat, Talat Bessissow, Diana E Yung, Tal Engel, Anastasios Koulaouzidis, Rami Eliakim, Shomron Ben-Horin, Uri Kopylov
BACKGROUND: Studies have confirmed an increased risk of colorectal cancer in patients with ulcerative colitis; hence, surveillance is recommended. Optional modalities include white light endoscopy (WLE) or dye-spray chromoendoscopy. However, narrow-band imaging (NBI) is still not considered comparable to chromoendoscopy. AIM: The aim of this study was to compare the diagnostic yield (DY) of WLE, chromoendoscopy, NBI for detection of neoplasia in patients with inflammatory bowel disease (IBD) by performing a meta-analysis of the existing literature...
November 2017: Digestive Diseases and Sciences
Margalida Calafat, Triana Lobatón, Alba Hernández-Gallego, Míriam Mañosa, Paola Torres, Fiorella Cañete, Eduard Cabré, Isabel Ojanguren, Eugeni Domènech
BACKGROUND: It has been suggested that acute histological activity has a prognostic value in the outcome of ulcerative colitis (UC) patients in clinical and endoscopic remission. Our aim was to assess the role of histology as a risk factor for clinical relapse (CR) in patients in both clinical and endoscopic remission. METHODS: Patients with left-sided or extensive UC in clinical and endoscopic remission (Mayo endoscopic subscore ≤1) undergoing colonoscopy for dysplasia surveillance with random colonic biopsies between 2005-2015 were included...
December 2017: Digestive and Liver Disease
Ryosuke Yamauchi, Ken Kominato, Keiichi Mitsuyama, Hidetoshi Takedatsu, Shinichiro Yoshioka, Kotaro Kuwaki, Hiroshi Yamasaki, Shuhei Fukunaga, Atsushi Mori, Jun Akiba, Osamu Tsuruta, Takuji Torimura
Patients with longstanding ulcerative colitis have an increased risk of colorectal cancer. Mouse models for colitis-associated tumors are indispensable for the development of novel strategies for prevention and intervention, as well as an improved understanding of the mechanisms underlying tumor formation. The present study examined whether stereomicroscopic observations with dye-application were able to detect and discriminate tumors in a colitis-associated tumor model in mice. Colonic tumors were induced in C57BL/6 mice by 15 cycles of treatment with dextran sulfate sodium (DSS) in drinking water...
September 2017: Oncology Letters
William A Bye, Tran M Nguyen, Claire E Parker, Vipul Jairath, James E East
BACKGROUND: Patients with longstanding ulcerative colitis and colonic Crohn's disease have an increased risk of colorectal cancer (CRC) compared with the general population. This review assessed the evidence that endoscopic surveillance may prolong life by allowing earlier detection of CRC or its pre-cursor lesion, dysplasia, in patients with inflammatory bowel disease (IBD). OBJECTIVES: To assess the effectiveness of cancer surveillance programs for diagnosis of IBD-associated colorectal cancer and in reducing the mortality rate from colorectal cancer in patients with IBD...
September 18, 2017: Cochrane Database of Systematic Reviews
Marie Hanaoka, Toshiaki Ishikawa, Megumi Ishiguro, Michiyo Tokura, Shinichi Yamauchi, Akifumi Kikuchi, Hiroyuki Uetake, Masamichi Yasuno, Tatsuyuki Kawano
BACKGROUND: Diagnosis of low-grade dysplasia (LGD) is important in the management of ulcerative colitis (UC), but it is often difficult to distinguish LGD from inflammatory regenerative epithelium. The unfolded protein response (UPR) is activated in inflammatory bowel disease and malignancies. We aimed to identify a UPR-related gene that is involved in the development of non-UC and UC-associated colorectal cancer (CRC), and to investigate whether the target gene is useful for the diagnosis of LGD...
September 7, 2017: Journal of Gastroenterology
Ben Parker, James Buchanan, Sarah Wordsworth, Satish Keshav, Bruce George, James E East
BACKGROUND AND AIMS: There is uncertainty regarding the optimal management of endoscopically invisible (flat) low-grade dysplasia in ulcerative colitis. Such a finding does not currently provide an automatic indication for colectomy; however, a recommendation of surveillance instead of surgery is controversial. The aim of this study was to determine the clinical and cost-effectiveness of colonoscopic surveillance versus colectomy for endoscopically invisible low-grade dysplasia of the colon in ulcerative colitis...
December 2017: Gastrointestinal Endoscopy
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