Cargando…

Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review

BACKGROUND/AIMS: Ulcerative colitis (UC) patients are at greater risk for the development of colorectal neoplasia. Several individual studies have demonstrated associations between severity of histologic inflammation and colorectal neoplasia. However, a comprehensive systematic review has not been c...

Descripción completa

Detalles Bibliográficos
Autores principales: Colman, Ruben J., Rubin, David T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Association for the Study of Intestinal Diseases 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945523/
https://www.ncbi.nlm.nih.gov/pubmed/27433141
http://dx.doi.org/10.5217/ir.2016.14.3.202
_version_ 1782442884154261504
author Colman, Ruben J.
Rubin, David T.
author_facet Colman, Ruben J.
Rubin, David T.
author_sort Colman, Ruben J.
collection PubMed
description BACKGROUND/AIMS: Ulcerative colitis (UC) patients are at greater risk for the development of colorectal neoplasia. Several individual studies have demonstrated associations between severity of histologic inflammation and colorectal neoplasia. However, a comprehensive systematic review has not been completed. We performed a systematic review and meta-analysis to explore the relationship between histologic inflammation and risk for neoplasia among available observational studies. METHODS: Three databases (EMBASE, MEDLINE and the Cochrane Library) were systematically searched. Studies were included if they included UC patients who underwent colonoscopic assessment and when histologic inflammation and colorectal neoplasia were both reported. Colorectal neoplasia rates were compared. Quantitative meta-analysis was attempted. RESULTS: Four of 1,422 records found were eligible. Results from 2 case-control studies reported a 3.5-fold increased risk for colorectal neoplasia associated with a single point increase in histologic inflammation. This result was further corroborated by one cohort study that demonstrated increased hazard ratios. The second cohort study reported outcomes for patients with normal gross endoscopy, but had increased histological inflammation when neoplasia was assessed. Finally, this study reported increased risk for neoplastic progression by histological inflammation among patients who were normal by gross endoscopic evaluation. Quantitative meta-analysis was unsuccessful due to heterogeneity between study measures. CONCLUSIONS: There is strong evidence that histologic inflammation among patients with UC increases the risk of colorectal neoplasia. The depth and nature of assessment of additional clinical variables was varied and may have resulted in greater outcome discrepancy. Additional study related to mechanisms of inflammation-related neoplasia and therapeutic modification is needed.
format Online
Article
Text
id pubmed-4945523
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Korean Association for the Study of Intestinal Diseases
record_format MEDLINE/PubMed
spelling pubmed-49455232016-07-18 Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review Colman, Ruben J. Rubin, David T. Intest Res Systematic Review BACKGROUND/AIMS: Ulcerative colitis (UC) patients are at greater risk for the development of colorectal neoplasia. Several individual studies have demonstrated associations between severity of histologic inflammation and colorectal neoplasia. However, a comprehensive systematic review has not been completed. We performed a systematic review and meta-analysis to explore the relationship between histologic inflammation and risk for neoplasia among available observational studies. METHODS: Three databases (EMBASE, MEDLINE and the Cochrane Library) were systematically searched. Studies were included if they included UC patients who underwent colonoscopic assessment and when histologic inflammation and colorectal neoplasia were both reported. Colorectal neoplasia rates were compared. Quantitative meta-analysis was attempted. RESULTS: Four of 1,422 records found were eligible. Results from 2 case-control studies reported a 3.5-fold increased risk for colorectal neoplasia associated with a single point increase in histologic inflammation. This result was further corroborated by one cohort study that demonstrated increased hazard ratios. The second cohort study reported outcomes for patients with normal gross endoscopy, but had increased histological inflammation when neoplasia was assessed. Finally, this study reported increased risk for neoplastic progression by histological inflammation among patients who were normal by gross endoscopic evaluation. Quantitative meta-analysis was unsuccessful due to heterogeneity between study measures. CONCLUSIONS: There is strong evidence that histologic inflammation among patients with UC increases the risk of colorectal neoplasia. The depth and nature of assessment of additional clinical variables was varied and may have resulted in greater outcome discrepancy. Additional study related to mechanisms of inflammation-related neoplasia and therapeutic modification is needed. Korean Association for the Study of Intestinal Diseases 2016-07 2016-06-27 /pmc/articles/PMC4945523/ /pubmed/27433141 http://dx.doi.org/10.5217/ir.2016.14.3.202 Text en © Copyright 2016. Korean Association for the Study of Intestinal Diseases. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Systematic Review
Colman, Ruben J.
Rubin, David T.
Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review
title Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review
title_full Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review
title_fullStr Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review
title_full_unstemmed Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review
title_short Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review
title_sort histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945523/
https://www.ncbi.nlm.nih.gov/pubmed/27433141
http://dx.doi.org/10.5217/ir.2016.14.3.202
work_keys_str_mv AT colmanrubenj histologicalinflammationincreasestheriskofcolorectalneoplasiainulcerativecolitisasystematicreview
AT rubindavidt histologicalinflammationincreasestheriskofcolorectalneoplasiainulcerativecolitisasystematicreview