Target biopsy or step biopsy? Optimal surveillance for ulcerative colitis: a Japanese nationwide randomized controlled trial
Target biopsy or step biopsy? Optimal surveillance for ulcerative colitis: a Japanese nationwide randomized controlled trial
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DOI：
10.1007/s00535-010-0327-0
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发表时间：
2011-01-01
影响因子：
6.3
通讯作者：
Hibi, Toshifumi
中科院分区：
文献类型：
--
作者：
Watanabe, Toshiaki;Ajioka, Yoichi;Hibi, Toshifumi
结肠直肠癌是溃疡性结肠炎（UC）的并发症之一，随着疾病持续时间的延长，癌症的风险增加。结肠镜检查对于大肠癌的早期发现和早期治疗非常重要，尤其是对于长期UC。由于在内镜下并不总是容易检测到UC中的肿瘤性病变，指南建议在监测中使用分步活检，即每10 cm获得4份活检标本或总共获得33份或更多活检标本。然而，已经指出，获得几十个活检样本的分步活检在对患者的侵入性或医疗成本方面可能不是理想的方法。最近的研究报告了靶活检的有用性，而不是分步活检，其中活检组织仅从疑似肿瘤形成的区域获得。因此，日本厚生劳动省难治性炎症性肠病研究小组启动了一项随机对照研究，以比较分步活检和靶向活检的疗效。本文介绍了这一正在日本进行的随机对照试验。
Colorectal cancer is one of the complications of ulcerative colitis (UC) and the risk of cancer increases as the duration of the disease becomes longer. Surveillance colonoscopy has been considered to be important for the early detection and early treatment of colorectal cancer, especially in longstanding UC. Because it is not always easy to detect neoplastic lesions in UC endoscopically, guidelines recommend the use of step biopsy in surveillance, in which either 4 biopsy specimens for every 10 cm or a total of 33 or more biopsy specimens are obtained. However, it has been pointed out that a step biopsy obtaining several tens of biopsy specimens may not be an ideal method in terms of invasiveness to the patient or medical cost. Instead of step biopsy, recent studies report the usefulness of target biopsy, in which biopsy tissues are obtained only from regions suspected of neoplasia. Therefore, the Research Group for Intractable Inflammatory Bowel Disease of the Ministry of Health, Labour and Welfare of Japan has initiated a randomized controlled study to compare the efficacy of step biopsy and target biopsy. The present article gives an introduction to this ongoing randomized controlled trial in Japan.