LOW INCIDENCE OF SIGNIFICANT DYSPLASIA IN A SUCCESSFUL ENDOSCOPIC SURVEILLANCE PROGRAM OF PATIENTS WITH ULCERATIVE-COLITIS

被引:75
作者
ROZEN, P
BARATZ, M
FEFER, F
GILAT, T
机构
[1] TEL AVIV MED CTR & SCH MED,DEPT PATHOL,IL-64239 TEL AVIV,ISRAEL
[2] TEL AVIV UNIV,SACKLER FAC MED,IL-69978 TEL AVIV,ISRAEL
关键词
D O I
10.1016/0016-5085(95)90683-5
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background/Aims: Colorectal cancer associated with ulcerative colitis may be preceded by dysplastic changes potentially detectable by repeated endoscopic examinations. The aim of this study was to evaluate the incidence, course, and risk factors for dysplasia in a prospective endoscopic study. Methods: One hundred fifty-four patients with ulcerative colitis for 7 or more years' duration were followed from 1976 to 1994 in an endoscopic surveillance program. Results: Five patients had 10 adenomatous polyps managed by polypectomy. Indefinite dysplasia was found in 16 patients, and none showed progressive dysplasia on follow-up. Low-grade dysplasia was detected in 10 patients; 2 had and 2 progressed to high-grade dysplasia. High-grade dysplasia was found in 7 patients; 4 were concurrent with or just preceded cancer. All 4 cases of cancer were first detected by surveillance, and 3 were successfully treated. Significant risk factors for dysplasia (all grades) and cancer included the extent of disease (P < 0.01), older age at onset of colitis (P = 0.01), and the duration of disease (P < 0.05). The adjusted risk for cancer was significantly increased (P = 0.04). Conclusions: Indefinite dysplasia did not predict developing cancer. Low- or high-grade dysplasia was not frequent (8.5%) but was associated with progression to cancer. These can be detected and successfully treated by systematic endoscopic surveillance of patients with chronic (greater than or equal to 7 years), extensive (more than the rectosigmoid colon) ulcerative colitis.
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页码:1361 / 1370
页数:10
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