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Risk of Development of More-advanced Lesions in Patients With Inflammatory Bowel Diseases and Dysplasia
| Content Provider | Scilit |
|---|---|
| Author | Cremer, Anneline Demetter, Pieter Vos, Martine De Rahier, Jean-François Baert, Filip Moreels, Tom Macken, Elisabeth Louis, Edouard Ferdinande, Liesbeth Fervaille, Caroline Dedeurwaerdere, Franceska Bletard, Noela Driessen, Ann Hertogh, Gert De Vermeire, Séverine Franchimont, Denis |
| Copyright Year | 2019 |
| Description | Journal: Clinical Gastroenterology and Hepatology Background & Aims Patients with inflammatory bowel diseases (IBD) have increased risks of dysplasia and colitis-associated cancer (CAC). We evaluated the risk of development of high-grade dysplasia (HGD) or CAC after diagnosis of dysplasia using data from a national cohort of patients with IBD. Methods We performed a multicenter retrospective analysis of data collected from 7 tertiary referral regional or academic centers in Belgium. In searches of IBD pathology databases, we identified 813 lesions (616 low-grade dysplasias [LGDs], 64 high-grade dysplasias [HGDs], and 133 CACs) in 410 patients with IBD: 299 had dysplasia (73%) and 111 had CAC (27%). The primary aim was to determine the risk of more-advanced lesions after diagnosis of LGD or HGD. Results Of the 287 patients with LGD, 21 (7%) developed more-advanced lesions (HGD or CAC) after a median time period of 86 months (interquartile range, 34–214). Of the 28 patients with HGD, 4 (14%) developed CAC after a median time period of 180 months (interquartile range, 23–444). The overall cumulative incidence of CAC at 10 years after an initial diagnosis of HGD was 24.3% and after an initial diagnosis of LGD was 8.5% (P < .05). Metachronous lesions, non-polypoid lesions, and colonic stricture were associated with risk of occurrence of more-advanced lesions after LGD (P < .05). Of the 630 dysplastic lesions identified during endoscopy, 545 (86%) were removed during the same procedure or during a follow-up endoscopy or by surgery. Of 111 patients with CAC, 95 (86%) did not have prior detection of dysplasia and 64 of these 95 patients (67%) developed CAC outside of the screening or surveillance period recommended by the European Crohn's and Colitis Organisation. Conclusions In an analysis of pathology data from 7 medical centers in Belgium, we found a low rate of detection of more-advanced lesions following detection of LGD or HGD—taking into account that most of the lesions were removed. Main risk factors for development of more-advanced lesions after LGD were metachronous lesions, non-polypoid lesions, and colon strictures. |
| Related Links | https://dipot.ulb.ac.be/dspace/bitstream/2013/302662/5/cremer2019.pdf http://www.cghjournal.org/article/S1542356519306457/pdf |
| ISSN | 15423565 |
| e-ISSN | 15427714 |
| DOI | 10.1016/j.cgh.2019.05.062 |
| Journal | Clinical Gastroenterology and Hepatology |
| Issue Number | 7 |
| Volume Number | 18 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2019-06-13 |
| Access Restriction | Open |
| Subject Keyword | Journal: Clinical Gastroenterology and Hepatology Colorectal Cancer Endoscopy Resection Ulcerative Colitis Colitis-associated Colorectal Cancer Confidence Interval European Crohn's and Colitis Organisation High-grade Dysplasia Inflammatory Bowel Disease Interquartile Range Low-grade Dysplasia |
| Content Type | Text |
| Resource Type | Article |
| Subject | Hepatology Gastroenterology |
