Dye spraying and magnifying endoscopy for dysplasia and cancer surveillance in ulcerative colitis
Dye spraying and magnifying endoscopy for dysplasia and cancer surveillance in ulcerative colitis
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DOI：
10.1007/s10350-004-0682-0
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发表时间：
2004-11-01
影响因子：
3.9
通讯作者：
Mitorni, H
中科院分区：
文献类型：
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作者：
Sada, M;Igarashi, M;Mitorni, H
目的：探讨放大内窥镜对溃疡性结肠炎不典型增生或结肠癌的诊断价值。方法：1986-2000年间，886例溃疡性结肠炎患者在北里大学东院就诊。结果：345例广泛性结肠炎患者中11例(3.2%)发现不典型增生，217例左半结肠炎患者中8例(3.7%)发现不典型增生。9名(2.6%)广泛性结肠炎患者被诊断为结直肠癌，2名(0.9%)左侧结肠炎患者被诊断为结直肠癌。直肠炎型结肠炎患者均未发现异型增生和结肠癌。在内窥镜下，不典型增生和早期癌的特点是颗粒状或结节状突出的粘膜或低突起或扁平的粘膜，常伴有红肿。染料喷雾内窥镜检查是有用的。10个异型增生区域(7例)和5个早期癌(4例)的放大内窥镜检查显示His~IIIL型凹陷或IV型凹陷。放大内窥镜下肿瘤凹陷部位的活组织检查显示不典型增生和早期癌症。结论：染料喷洒和放大内窥镜检查有助于溃疡性结肠炎患者异型增生和结肠癌的发现、靶向活检和诊断。
PURPOSE: The aim of this study was to investigate detection of dysplasia or colitic cancer with ulcerative colitis by use of magnifying endoscopic observation.METHODS: From 1986 through 2000, ulcerative colitis was diagnosed and treated in 886 patients at Kitasato University East Hospital. Of the total, we studied 25 patients in depth: 14 who had dysplasia alone, 5 in whom cancer was diagnosed during follow-up after the detection of dysplasia, and 6 who had colitic cancer.RESULTS: Dysplasia was detected in 11 (3.2 percent) of 345 patients with extensive colitis and in 8 (3.7 percent) of 217 with left-sided colitis. Colorectal cancer was diagnosed in nine patients (2.6 percent) with extensive colitis and ill two (0.9 percent) with left-sided colitis. Neither dysplasia nor colitic cancer was found in patients with proctitis-type colitis. Endoscopically, dysplasia and early cancer were characterized by granular or nodular protruding mucosa or by lowly protruding or flat mucosa, often associated with redness. Dye-spraying endoscopy was useful for detection. Magnifying endoscopy of ten regions of dysplasia (7 patients) and five early cancers (4 patients) showed HIS to IIIL type pits or IV type pits. Biopsy of sites showing tumorous pits on magnifying endoscopy revealed dysplasia and early cancer. Observation of the pit pattern was found to be diagnostically useful.CONCLUSIONS: Dye spraying and magnifying endoscopy are useful for the detection, targeted biopsy, and diagnosis of dysplasia and colitic cancer in patients with ulcerative colitis.