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Endoscopic visualization of cancer and dysplasia in patients with ulcerative colitis following sensitization with oral 5‐aminolevulinic acid

OBJECTIVE: Early diagnosis of colitis‐associated cancer and dysplasia through surveillance endoscopy is vital for patients with ulcerative colitis (UC). This study aimed to evaluate the efficacy of autofluorescence endoscopy (AFE) using 5‐aminolevulinic acid (ALA) and to investigate the fluorescence...

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Autores principales: Kato, Tomohiro, Iwasaki, Tetsuyoshi, Arihiro, Seiji, Saruta, Masayuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Publishing Asia Pty Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590119/
https://www.ncbi.nlm.nih.gov/pubmed/32686910
http://dx.doi.org/10.1111/1751-2980.12923
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author Kato, Tomohiro
Iwasaki, Tetsuyoshi
Arihiro, Seiji
Saruta, Masayuki
author_facet Kato, Tomohiro
Iwasaki, Tetsuyoshi
Arihiro, Seiji
Saruta, Masayuki
author_sort Kato, Tomohiro
collection PubMed
description OBJECTIVE: Early diagnosis of colitis‐associated cancer and dysplasia through surveillance endoscopy is vital for patients with ulcerative colitis (UC). This study aimed to evaluate the efficacy of autofluorescence endoscopy (AFE) using 5‐aminolevulinic acid (ALA) and to investigate the fluorescence signal localization pattern following 5‐ALA administration in tumorous lesions diagnosed as colitis‐associated cancer and dysplasia. The sensitivity and specificity of tumorous lesions detected by white light endoscopy (WLE) with and without AFE were evaluated. METHODS: Overall, 13 endoscopic procedures were performed in 11 patients with UC using WLE and AFE following the oral administration of 5‐ALA. The biopsied lesions detected via endoscopy and resected specimens from cases underwent colectomy were assessed histopathologically. The sensitivity and specificity of detecting tumorous lesions by WLE with and without AFE were evaluated. RESULTS: Of the 68 lesions detected and biopsied, 63 were detected via WLE, and five were detected via AFE alone. The sensitivity of detecting colitis‐associated cancer and dysplasia via WLE combined with AFE was 36.4%, and the specificity, positive predictive value and negative predictive value were 94.2%, 57.1%, and 87.5%, respectively. Tumorous lesions displayed three types of fluorescence patterns on AFE. CONCLUSIONS: AFE using 5‐ALA can detect colitis‐associated cancer and dysplasia in patients with long‐standing UC and lesions that could not be detected via WLE. The distinctive fluorescence patterns in lesions may permit qualitative diagnoses of colitis‐associated cancer and dysplasia.
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spelling pubmed-75901192020-10-30 Endoscopic visualization of cancer and dysplasia in patients with ulcerative colitis following sensitization with oral 5‐aminolevulinic acid Kato, Tomohiro Iwasaki, Tetsuyoshi Arihiro, Seiji Saruta, Masayuki J Dig Dis Original Articles OBJECTIVE: Early diagnosis of colitis‐associated cancer and dysplasia through surveillance endoscopy is vital for patients with ulcerative colitis (UC). This study aimed to evaluate the efficacy of autofluorescence endoscopy (AFE) using 5‐aminolevulinic acid (ALA) and to investigate the fluorescence signal localization pattern following 5‐ALA administration in tumorous lesions diagnosed as colitis‐associated cancer and dysplasia. The sensitivity and specificity of tumorous lesions detected by white light endoscopy (WLE) with and without AFE were evaluated. METHODS: Overall, 13 endoscopic procedures were performed in 11 patients with UC using WLE and AFE following the oral administration of 5‐ALA. The biopsied lesions detected via endoscopy and resected specimens from cases underwent colectomy were assessed histopathologically. The sensitivity and specificity of detecting tumorous lesions by WLE with and without AFE were evaluated. RESULTS: Of the 68 lesions detected and biopsied, 63 were detected via WLE, and five were detected via AFE alone. The sensitivity of detecting colitis‐associated cancer and dysplasia via WLE combined with AFE was 36.4%, and the specificity, positive predictive value and negative predictive value were 94.2%, 57.1%, and 87.5%, respectively. Tumorous lesions displayed three types of fluorescence patterns on AFE. CONCLUSIONS: AFE using 5‐ALA can detect colitis‐associated cancer and dysplasia in patients with long‐standing UC and lesions that could not be detected via WLE. The distinctive fluorescence patterns in lesions may permit qualitative diagnoses of colitis‐associated cancer and dysplasia. Wiley Publishing Asia Pty Ltd 2020-09-28 2020-09 /pmc/articles/PMC7590119/ /pubmed/32686910 http://dx.doi.org/10.1111/1751-2980.12923 Text en © 2020 The Authors. Journal of Digestive Diseases published by Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Kato, Tomohiro
Iwasaki, Tetsuyoshi
Arihiro, Seiji
Saruta, Masayuki
Endoscopic visualization of cancer and dysplasia in patients with ulcerative colitis following sensitization with oral 5‐aminolevulinic acid
title Endoscopic visualization of cancer and dysplasia in patients with ulcerative colitis following sensitization with oral 5‐aminolevulinic acid
title_full Endoscopic visualization of cancer and dysplasia in patients with ulcerative colitis following sensitization with oral 5‐aminolevulinic acid
title_fullStr Endoscopic visualization of cancer and dysplasia in patients with ulcerative colitis following sensitization with oral 5‐aminolevulinic acid
title_full_unstemmed Endoscopic visualization of cancer and dysplasia in patients with ulcerative colitis following sensitization with oral 5‐aminolevulinic acid
title_short Endoscopic visualization of cancer and dysplasia in patients with ulcerative colitis following sensitization with oral 5‐aminolevulinic acid
title_sort endoscopic visualization of cancer and dysplasia in patients with ulcerative colitis following sensitization with oral 5‐aminolevulinic acid
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590119/
https://www.ncbi.nlm.nih.gov/pubmed/32686910
http://dx.doi.org/10.1111/1751-2980.12923
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