Conventional Endoscopic Diagnosis ofColitic Cancer and Dysplasia Kiyonori Kobayashi 1 , Hitomi Takeuchi 1 , Satomi Haruki 1 , Kaoru Yokoyama 1 , Miwa Sada 1 , Tomoe Katsumata 1 , Katsunori Saigenji 1 1Department of Gastroenterology, Kitasato University East Hospital, Sagamihara, Japan Keyword: 潰瘍性大腸炎 , colitic cancer , dysplasia , 通常内視鏡診断 pp.1293-1301
Published Date 2008/8/25
DOI https://doi.org/10.11477/mf.1403101443
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 Patients with ulcerative colitis(UC)are at high risk for dysplasia and colitic cancer as can be seen during long-term follow-up. The early detection of UC-related neoplasm by colonoscopy requires an understanding of the characteristics of the endoscopic findings of these lesions. Among UC-related neoplasms treated in our hospital, we studied 23 lesions of dysplasia and 9 lesions of colitic cancer diagnosed by colonoscopy, excluding advanced cancer. The most common endoscopic finding leading to the detection of UC-related neoplasm was an elevated lesion for 22 tumors(69%), especially in colitic cancer. Flat lesions were detected in the areas with localized redness or an uneven surface of the mucosa. As for macroscopic appearance, a high proportion of UC-related neoplasms were elevated lesions. In particular, colitic cancer was frequently associated with nodular lesions. Seven lesions of dysplasia(30%)were flat lesions. As for tumor color, many lesions showed uneven redness. About half of the lesions were poorly demarcated. Lesions suspected to be UC-related neoplasms on endoscopic examination should be carefully evaluated after the application of dye to confirm the presence of lesions and to assess the surface structure in detail.

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