Stomach and Intestine(Tokyo) Volume 49, Issue 10 (September 2014)

Retrospective Study of Initial Lesions of Ulcerative Colitis-associated Colorectal Cancer on Endoscopic Examination : Focus on Conventional Endoscopy Miwa Sada 1 , Kiyonori Kobayashi 2 , Kana Kawagishi 1 , Shohei Ooka 1 , Kaoru Yokoyama 1 , Wasaburo Koizumi 1 , Makoto Saegusa 3 1Department of Gastroenterology, Kitasato University East Hospital, Sagamihara, Japan 2Research and Development Center for New Medical Frontiers, Kitasato University, School of Medicine, Sagamihara, Japan 3Department of Pathology, Kitasato University East Hospital, Sagamihara, Japan Keyword: 潰瘍性大腸炎 , colitic cancer , dysplasia , 通常内視鏡検査 pp.1446-1455
Published Date 2014/9/25
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 Patients with long-term ulcerative colitis are at increased risk of dysplasia and CC(ulcerative colitis-associated colorectal cancer). In our hospital, 32 lesions of dysplasia and 12 lesions of CC were evaluated by conventional endoscopy. Dysplasia was detected in a shorter period after disease onset than CC. Many patients with dysplasia had flat mucosa or flat surface protrusions. In contrast, CC was often associated with higher lesions than dysplasia, such as nodular and broad-based protrusions. Flat lesions were detected in areas of localized redness or uneven, irregular mucosal surfaces.

 A retrospective study of 15 low-grade dysplasia lesions indicated that five lesions presented morphologic changes during follow-up. Four of these lesions histopathologically progressed to high-grade dysplasia or CC. Five low-grade dysplasia lesions with morphologic changes were characterized by flat mucosa with regional redness, flat protrusions, uneven irregular mucosa, and slight depression on initial endoscopy. These findings suggested the presence of initial lesions of ulcerative colitis-related tumors.

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49巻10号 (2014年9月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院