Current Status and Problems of the Diagnosis of Ulcerative Colitis-associated Neoplasia on Conventional Endoscopy Kiyonori Kobayashi 1 , Jun Kanazawa 2 , Tomohiro Betto 2 , Kana Kawagishi 2 , Miyuki Mukae 2 , Kaoru Yokoyama 2 , Miwa Sada 2 , Wasaburo Koizumi 2 1Research and Development Center for New Medical Frontiers, Kitasato University, School of Medicine, Sagamihara, Japan 2Department of Gastroenterology, Kitasato University, School of Medicine, Sagamihara, Japan Keyword: 潰瘍性大腸炎関連腫瘍 , 通常内視鏡 , colitic cancer , dysplasia pp.133-141
Published Date 2020/2/25
DOI https://doi.org/10.11477/mf.1403201940
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 In this study, we used conventional endoscopy for the diagnosis of UCAN(ulcerative colitis-associated neoplasia). We reviewed 67 lesions of UCAN, 38 lesions of colitic cancer, and 29 lesions of dysplasia. The main findings using conventional endoscopy for detection of UCAN included presence of localized protrusions or redness. Furthermore, the concurrent use of chromoendoscopy was useful in the diagnostic process. Regarding the macroscopic type, majority of UCAN cases were of elevated type, and some cases of dysplasia were of flat type. Overall, 61% cases of colitic cancer and 34% cases of dysplasia were poorly demarcated, suggesting a characteristic finding of UCAN. Therefore, conventional endoscopy can identify several cases of colitic cancer from the respective UCAN lesions. On the other hand, the identification of flat-type lesions is quite difficult. Conclusively, when conventional endoscopy identifies characteristic findings, such as localized elevation, changes in color, surface irregularities, and depression in a site affected by UC, chromoendoscopy with target biopsy can subsequently facilitate and validate UCAN diagnosis. However, it is imperative to identify and locate the lesions that are difficult to diagnose using conventional endoscopy but also the lesions that are difficult to distinguish from sporadic adenoma and carcinoma.

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