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The optimum surveillance and endoscopic clues for ulcerative colitis associated colorectal cancer
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T. Shinagawa1,
K. Hata1,
T. Watanabe1 |
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1Department of Surgical Oncology, The University of Tokyo |
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| Background: Patients with longstanding ulcerative colitis (UC) are well known to be at high risk of developing colorectal cancer (UC-CRC) and effective surveillance colonoscopy to detect UC-CRC is crucial. We aimed to clarify the optimum surveillance colonoscopy to detect UC-CRC and elucidate the specific endoscopic target especially for the early stage UC-CRC.Methods: We retrospectively reviewed 62 patients with UC-CRC or dysplasia who underwent surgery at our institution. The characteristics of patients and neoplastic lesions were investigated. We further scrutinized recent 20 cases (27 lesions) between 2014 and 2017 to analyze endoscopic findings of T1/2 UC-CRC or dysplasia (13 cases and 20 lesions). We also examined surgical specimens using a stereomicroscope to correlate the pit patterns with the histological findings.Result: The location of neoplasia was the rectum or sigmoid colon in 50/62 cases (80.6%) and the extent of UC was total colitis in 57/62 cases (91.9%). The median age at UC onset and detection of neoplasia was 32 and 51 y/o, respectively. Colonoscopy at the time of neoplasia-detection was for surveillance in 16/20 patients (80%). Typical neoplastic pit patterns (III, IV, V) were observed in 15/20 lesions (75%) and redness was noted in 10/13 flat lesions (76.9%).Conclusion: The rectum and sigmoid colon should be thoroughly observed and endoscopic findings such as redness or typical pit patterns might be clues for detecting neoplastic lesions. |
Index Term 1: ulcerative colitis
Index Term 2: surveillance colonoscopy |
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