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Possible Earlier Diagnosis of Ulcerative Colitis-Associated Neoplasia: A Retrospective Analysis of Interval Cases during Surveillance

Background: Early detection of ulcerative colitis-associated neoplasia (UCAN) is often difficult. The aim of this study was to clarify the morphology of initial UCAN. Methods: White-light colonoscopy images obtained within the 2 years before UCAN diagnosis were retrospectively reviewed. The primary...

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Autores principales: Hisabe, Takashi, Matsui, Toshiyuki, Yamasaki, Kazutomo, Morokuma, Tsuyoshi, Aomi, Kenmei, Yoshizawa, Naoyuki, Takatsu, Noritaka, Yao, Kenshi, Ueki, Toshiharu, Futami, Kitaro, Tanabe, Hiroshi, Iwashita, Akinori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124807/
https://www.ncbi.nlm.nih.gov/pubmed/33946906
http://dx.doi.org/10.3390/jcm10091927
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author Hisabe, Takashi
Matsui, Toshiyuki
Yamasaki, Kazutomo
Morokuma, Tsuyoshi
Aomi, Kenmei
Yoshizawa, Naoyuki
Takatsu, Noritaka
Yao, Kenshi
Ueki, Toshiharu
Futami, Kitaro
Tanabe, Hiroshi
Iwashita, Akinori
author_facet Hisabe, Takashi
Matsui, Toshiyuki
Yamasaki, Kazutomo
Morokuma, Tsuyoshi
Aomi, Kenmei
Yoshizawa, Naoyuki
Takatsu, Noritaka
Yao, Kenshi
Ueki, Toshiharu
Futami, Kitaro
Tanabe, Hiroshi
Iwashita, Akinori
author_sort Hisabe, Takashi
collection PubMed
description Background: Early detection of ulcerative colitis-associated neoplasia (UCAN) is often difficult. The aim of this study was to clarify the morphology of initial UCAN. Methods: White-light colonoscopy images obtained within the 2 years before UCAN diagnosis were retrospectively reviewed. The primary endpoint was the frequency of visible or invisible neoplasia on the endoscopic images before UCAN diagnosis. The secondary endpoints were comparisons of (1) visible or invisible neoplasia on initial endoscopic images of early-stage and advanced cancers, (2) the clinical backgrounds of patients in whom neoplasia was visible or invisible on initial endoscopic images, and (3) the clinical backgrounds of patients with distinct and indistinct UCAN borders. Results: Of the 27 UCAN lesions (11 early-stage; 16 advanced-stage), 25.9% (n = 7) were initially visible and 74.1% (n = 20) were invisible. The mean interval between the last surveillance colonoscopy and UCAN diagnosis was 14.5 ± 6.7 months. Of early-stage cancers, 18.2% (n = 2) were visible and 81.8% (n = 9) were invisible. Of advanced-stage cancers, 31.3% (n = 5) were visible and 68.8% (n = 11) were invisible. Invisible lesions were significantly more common in the rectum (p = 0.011) and tended to be more common in patients with inflammation and left-sided colitis (p = 0.084, p = 0.068, respectively). Patients with indistinct UCAN borders were significantly more likely to present with inflammation than those with distinct UCAN borders (p = 0.021). Conclusion: More careful surveillance is needed because rectum lesions and inflammation are difficult to identify as neoplasia even within the 2 years before a UCAN diagnosis.
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spelling pubmed-81248072021-05-17 Possible Earlier Diagnosis of Ulcerative Colitis-Associated Neoplasia: A Retrospective Analysis of Interval Cases during Surveillance Hisabe, Takashi Matsui, Toshiyuki Yamasaki, Kazutomo Morokuma, Tsuyoshi Aomi, Kenmei Yoshizawa, Naoyuki Takatsu, Noritaka Yao, Kenshi Ueki, Toshiharu Futami, Kitaro Tanabe, Hiroshi Iwashita, Akinori J Clin Med Article Background: Early detection of ulcerative colitis-associated neoplasia (UCAN) is often difficult. The aim of this study was to clarify the morphology of initial UCAN. Methods: White-light colonoscopy images obtained within the 2 years before UCAN diagnosis were retrospectively reviewed. The primary endpoint was the frequency of visible or invisible neoplasia on the endoscopic images before UCAN diagnosis. The secondary endpoints were comparisons of (1) visible or invisible neoplasia on initial endoscopic images of early-stage and advanced cancers, (2) the clinical backgrounds of patients in whom neoplasia was visible or invisible on initial endoscopic images, and (3) the clinical backgrounds of patients with distinct and indistinct UCAN borders. Results: Of the 27 UCAN lesions (11 early-stage; 16 advanced-stage), 25.9% (n = 7) were initially visible and 74.1% (n = 20) were invisible. The mean interval between the last surveillance colonoscopy and UCAN diagnosis was 14.5 ± 6.7 months. Of early-stage cancers, 18.2% (n = 2) were visible and 81.8% (n = 9) were invisible. Of advanced-stage cancers, 31.3% (n = 5) were visible and 68.8% (n = 11) were invisible. Invisible lesions were significantly more common in the rectum (p = 0.011) and tended to be more common in patients with inflammation and left-sided colitis (p = 0.084, p = 0.068, respectively). Patients with indistinct UCAN borders were significantly more likely to present with inflammation than those with distinct UCAN borders (p = 0.021). Conclusion: More careful surveillance is needed because rectum lesions and inflammation are difficult to identify as neoplasia even within the 2 years before a UCAN diagnosis. MDPI 2021-04-29 /pmc/articles/PMC8124807/ /pubmed/33946906 http://dx.doi.org/10.3390/jcm10091927 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hisabe, Takashi
Matsui, Toshiyuki
Yamasaki, Kazutomo
Morokuma, Tsuyoshi
Aomi, Kenmei
Yoshizawa, Naoyuki
Takatsu, Noritaka
Yao, Kenshi
Ueki, Toshiharu
Futami, Kitaro
Tanabe, Hiroshi
Iwashita, Akinori
Possible Earlier Diagnosis of Ulcerative Colitis-Associated Neoplasia: A Retrospective Analysis of Interval Cases during Surveillance
title Possible Earlier Diagnosis of Ulcerative Colitis-Associated Neoplasia: A Retrospective Analysis of Interval Cases during Surveillance
title_full Possible Earlier Diagnosis of Ulcerative Colitis-Associated Neoplasia: A Retrospective Analysis of Interval Cases during Surveillance
title_fullStr Possible Earlier Diagnosis of Ulcerative Colitis-Associated Neoplasia: A Retrospective Analysis of Interval Cases during Surveillance
title_full_unstemmed Possible Earlier Diagnosis of Ulcerative Colitis-Associated Neoplasia: A Retrospective Analysis of Interval Cases during Surveillance
title_short Possible Earlier Diagnosis of Ulcerative Colitis-Associated Neoplasia: A Retrospective Analysis of Interval Cases during Surveillance
title_sort possible earlier diagnosis of ulcerative colitis-associated neoplasia: a retrospective analysis of interval cases during surveillance
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124807/
https://www.ncbi.nlm.nih.gov/pubmed/33946906
http://dx.doi.org/10.3390/jcm10091927
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