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Yeaman F, Thin L. The yield of dysplasia and serrated lesions in a single-centre tertiary inflammatory bowel disease cohort. Therap Adv Gastroenterol 2023; 16:17562848231167280. [PMID: 37153500 PMCID: PMC10161306 DOI: 10.1177/17562848231167280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/14/2023] [Indexed: 05/09/2023] Open
Abstract
Background Chromoendoscopy is preferred over high-definition white light endoscopy (HDWLE) for dysplasia surveillance in inflammatory bowel disease (IBD) patients, but is more time-consuming to perform and real-world evidence is limited. The prevalence of sessile serrated lesions (SSLs) in IBD patients is also unknown. Objective To determine the yield of polypoid and non-polypoid dysplasia and SSLs in IBD patients undergoing dysplasia surveillance and the associations for these lesions. Design A retrospective cohort study from a tertiary IBD centre. Methods A keyword search of the colonoscopy reporting system was performed. IBD patients with colonic disease that underwent colonoscopy for surveillance between 1 February 2015 and 1 February 2018 were included. Clinical, endoscopic and histopathological outcomes were extracted for the analysis. Results Of 2114 patients identified, 276 eligible colonoscopies in 126 patients were analysed. The median age at colonoscopy was 51 years (interquartile range: 42-58 years). 71/126 (56%) of colonoscopies were performed in male patients, with 57/126 (45%) having ulcerative colitis, 68/126 (54%) Crohn's colitis and 1/126 (0.79%) IBD-unspecified. The prevalence for any neoplasia was 75/276 (27%). The prevalence for all serrated lesions was 43/276 (16%). Increased age was a risk factor for finding a neoplastic lesion on both univariate and multivariate analyses. Chromoendoscopy was associated with twice the odds of finding a neoplastic lesion (odds ratio: 1.99, 95% confidence interval: 1.13-3.51, p = 0.02), on multivariate analysis. No factor was associated with an increased risk of finding a serrated lesion. Conclusion Significant neoplastic lesions and serrated lesions were detected in 27% and 16% of colonoscopies performed in IBD patients, respectively, with the highest yield in older patients. Chromoendoscopy significantly increased neoplasia yield compared to HDWLE and still has a robust utility in this pragmatic real-world study.
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Affiliation(s)
- Fiona Yeaman
- Department of Gastroenterology, Fiona Stanley Hospital, Murdoch, WA, Australia
- Department of Internal Medicine, UWA Medical School, University of Western Australia, Perth, WA, Australia
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2
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Pereira D, Kővári B, Brown I, Chaves P, Choi WT, Clauditz T, Ghayouri M, Jiang K, Miller GC, Nakanishi Y, Kim KM, Kim BH, Kumarasinghe MP, Kushima R, Ushiku T, Yozu M, Srivastava A, Goldblum JR, Pai RK, Lauwers GY. Non-conventional dysplasias of the tubular gut: a review and illustration of their histomorphological spectrum. Histopathology 2021; 78:658-675. [PMID: 33124049 DOI: 10.1111/his.14294] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The increasing use of gastrointestinal endoscopic procedures has led to the recognition by histopathologists of non-conventional (or special-type) dysplasias of the gastrointestinal tract. These lesions can be recognised in association with prevalent underlying gastrointestinal conditions, such as Barrett oesophagus, chronic atrophic gastritis, and inflammatory bowel disease. The diagnosis of these special types can be challenging, and their biological behaviours are not fully characterised. The aim of this review is to provide a global view of non-conventional dysplastic lesions observed in the various segments of the tubular gastrointestinal tract and describe their salient features. Furthermore, as the clinical implications of these various subtypes have not been broadly tested in practice and are not represented in most management guidelines, we offer guidance on the best management practices for these lesions.
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Affiliation(s)
- Daniela Pereira
- Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa de Francisco Gentil-EPE (IPOLFG EPE), Lisboa, Portugal.,Faculdade de Ciências da Saúde, Universidade da Beira Interior (FCS UBI), Covilhã, Portugal
| | - Bence Kővári
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Pathology, University of Szeged, Szeged, Hungary.,Albert Szent-Györgyi Health Centre, Szeged, Hungary
| | - Ian Brown
- Envoi Specialist Pathologists, Brisbane, Qld, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia
| | - Paula Chaves
- Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa de Francisco Gentil-EPE (IPOLFG EPE), Lisboa, Portugal.,Faculdade de Ciências da Saúde, Universidade da Beira Interior (FCS UBI), Covilhã, Portugal
| | - Won-Tak Choi
- Department of Pathology, University of California at San Francisco, San Francisco, CA, USA
| | - Till Clauditz
- Department of Pathology, University-Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Masoumeh Ghayouri
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Pathology and Cell Biology, University of South Florida, Tampa, FL, USA.,Department of Oncological Sciences, University of South Florida, Tampa, FL, USA
| | - Kun Jiang
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Pathology and Cell Biology, University of South Florida, Tampa, FL, USA.,Department of Oncological Sciences, University of South Florida, Tampa, FL, USA
| | - Gregory C Miller
- Envoi Specialist Pathologists, Brisbane, Qld, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Qld, Australia
| | - Yukihiro Nakanishi
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Pathology and Cell Biology, University of South Florida, Tampa, FL, USA.,Department of Oncological Sciences, University of South Florida, Tampa, FL, USA
| | - Kyoung M Kim
- Department of Pathology, Samsung Medical Centre, Seoul, Korea
| | - Baek H Kim
- Department of Pathology, Korea University Guro Hospital, Seoul, Korea
| | | | - Ryoji Kushima
- Department of Pathology, Shiga University of Medical Science, Otsu, Japan
| | - Tetsuo Ushiku
- Department of Pathology, The University of Tokyo, Tokyo, Japan
| | - Masato Yozu
- Histopathology Department, Middlemore Hospital, Auckland, New Zealand
| | | | - John R Goldblum
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Rish K Pai
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Gregory Y Lauwers
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Pathology and Cell Biology, University of South Florida, Tampa, FL, USA.,Department of Oncological Sciences, University of South Florida, Tampa, FL, USA
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3
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Ashktorab H, Brim H, Hassan S, Nouraie M, Gebreselassie A, Laiyemo AO, Kibreab A, Aduli F, Latella G, Brant SR, Sherif Z, Habtezion A. Inflammatory polyps occur more frequently in inflammatory bowel disease than other colitis patients. BMC Gastroenterol 2020; 20:170. [PMID: 32503428 PMCID: PMC7275388 DOI: 10.1186/s12876-020-01279-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 04/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colitis is generally considered a risk factor for colon neoplasia. However, not all types of colitis seem to have equal neoplastic transformation potential. AIM To determine the prevalence of colorectal polyps in a predominantly African American population with inflammatory bowel disease (IBD) and Non-IBD/Non-Infectious Colitis (NIC). METHODS We retrospectively evaluated medical records of 1060 patients previously identified with colitis at Howard University Hospital, based on ICD-10 code. Among these, 485 patients were included in the study: 70 IBD and 415 NIC based on a thorough review of colonoscopy, pathology and clinical reports. Logistic regression analysis was applied to estimate the risk of polyps in patients with IBD compared to those with NIC after adjusting for age and sex. A subgroup analysis within the IBD group was performed. RESULTS Of the 485 patients, 415 were NIC and 70 were IBD. Seventy-three percent of the NIC patients and 81% of the IBD patients were African Americans. Forty six percent of IBD and 41% of NIC cases were male. IBD patients were younger than NIC patients (median age of 38 years vs. 50, P < 0.001). The prevalence of all types of polyps was 15.7 and 8.2% in the IBD and NIC groups, respectively (P = 0.045). Among patients with polyps, the prevalence of inflammatory polyps was higher in the IBD group (55%) compared to the NIC group (12%). After adjusting for age, sex and race, odds ratio of inflammatory polyps in IBD patients was 6.0 (P = 0.016). Adenoma prevalence was 4.3% (3/70) in IBD patients and 3.9% (16/415) in the NIC patients (p = 0.75). The anatomic distribution of lesions and colitis shows that polyps occur predominantly in the colitis field regardless of colitis type. More polyps were present in the ulcerative colitis patients when compared to Crohn's disease patients (27% vs. 5%, P < 0.001) within the IBD group. CONCLUSION Our study shows that inflammatory polyps are more common in IBD patients when compared to NIC patients. Most polyps were in the same location as the colitis.
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Affiliation(s)
- Hassan Ashktorab
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA.
| | - Hassan Brim
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Sally Hassan
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Mehdi Nouraie
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Agazi Gebreselassie
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Adeyinka O Laiyemo
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Angesom Kibreab
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Farshad Aduli
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | | | - Steven R Brant
- Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, and and Department of Genetics and The Human Genetics Institute of New Jersey, Rutgers University, New Brunswick, New Jersey, USA
- Harvey M. and Lyn P. Meyerhoff Inflammatory Bowel Disease Center, Division of Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Zaki Sherif
- Department of Medicine, Department of Pathology and Cancer Center, Howard University Collerge of Medicine, 2041 Georgia Avenue, N.W., Washington, D.C, 20060, USA
| | - Aida Habtezion
- Gastroenterology division, Stanford University, School of Medicine, Palo Alto, California, USA
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4
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Gui X, Iacucci M, Ghosh S, Ferraz JGP, Lee S. Revisiting the distinct histomorphologic features of inflammatory bowel disease-associated neoplastic precursor lesions in the SCENIC and post-DALM Era. Hum Pathol 2020; 100:24-37. [PMID: 32387105 DOI: 10.1016/j.humpath.2020.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 02/07/2023]
Abstract
Distinct histomorphologic features of colitis-associated dysplasia (CAD) or neoplastic precursors in inflammatory bowel disease (IBD) have never been clearly identified. In this study, we tried to further explore the differentiating morphologic features of CAD by retrospectively reviewing the lesions that were clearly associated with carcinomas (carcinoma-related lesions) and by comparing between endoscopically nonpolypoid (non-adenoma-like) lesions and polypoid (adenoma-like) lesions and sporadic conventional adenomas found in the noncolitic mucosa and in patients without IBD. Our study results have revealed that (1) precursor lesions related to IBD-associated colorectal carcinomas were almost always nonpolypoid in macroscopic/endoscopic appearance; (2) nearly half of the carcinoma-related lesions and nonpolypoid lesions were similarly nonadenomatous (nonconventional) lesions, largely serrated type, with no or only mild/focal adenomatous dysplasia, and commonly had mixed adenomatous and nonadenomatous features; (3) carcinoma-related and nonpolypoid adenomatous dysplastic lesions frequently showed some peculiar histocytologic features that we observed and described for the first time, including mixed features of inflammatory pseudopolyps or granulation tissue, pleomorphic and disarrayed nuclei, micropapillary or hobnailing surface epithelial cells, and microvesicular or bubbling cytoplasm of dysplastic cells; and (4) polypoid lesions in the colitic mucosa were identical to sporadic adenomas in the noninflamed mucosa and in patients without IBD, and they lacked the aforementioned features. The seemingly distinctive morphologic characteristics that we proposed here, although still not absolutely specific or unique, can be used as the features of inclusion for identifying CAD on endoscopic biopsies when the endoscopy images are not readily available to pathologists and thus to alert clinicians for a closer follow-up.
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Affiliation(s)
- Xianyong Gui
- Department of Pathology, University of Washington School of Medicine, Seattle, 98195, USA; Department of Pathology and Laboratory Medicine, University of Calgary Cummings School of Medicine, Calgary, T2N 4N1, Canada.
| | - Marietta Iacucci
- Division of Gastroenterology, University of Calgary Cummings School of Medicine, Calgary, T2N 4N1, Canada; NIHR Biomedical Research Centre, Institute of Translational Medicine, University of Birmingham, Birmingham, B15 2TH, UK
| | - Subrata Ghosh
- Division of Gastroenterology, University of Calgary Cummings School of Medicine, Calgary, T2N 4N1, Canada; NIHR Biomedical Research Centre, Institute of Translational Medicine, University of Birmingham, Birmingham, B15 2TH, UK
| | - Jose G P Ferraz
- Division of Gastroenterology, University of Calgary Cummings School of Medicine, Calgary, T2N 4N1, Canada
| | - Scott Lee
- Division of Gastroenterology, University of Washington School of Medicine, Seattle, 98195, USA
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5
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Gui X, Köbel M, Ferraz JG, Iacucci M, Ghosh S, Liu S, Ou Y, Perizzolo M, Winkfein RJ, Rambau P, Demetrick DJ. Histological and molecular diversity and heterogeneity of precancerous lesions associated with inflammatory bowel diseases. J Clin Pathol 2019; 73:391-402. [PMID: 31801800 DOI: 10.1136/jclinpath-2019-206247] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/05/2019] [Accepted: 11/06/2019] [Indexed: 01/08/2023]
Abstract
AIMS Inflammatory bowel disease (IBD)-associated precancerous lesions may be adenomatous or non-adenomatous with various histomorphologies. We aim to validate the newly proposed classification, to explore the neoplastic nature of the non-adenomatous lesions and to elucidate the molecular mechanisms underlying the different histomorphologies. METHODS 44 background precursor lesions identified in 53 cases of surgically resected IBD-associated colorectal and ileal carcinomas were reviewed for the histomorphological features (classified into adenomatous, mucinous, sessile serrated adenoma (SSA)-like, traditional serrated adenoma-like, differentiated, eosinophilic and serrated not otherwise specified (NOS)) and analysed for a key panel of colonic cancer-related molecular markers. RESULTS Approximately 60% of the lesions were adenomatous, of which some had mixed serrated, mucinous or eosinophilic changes. The remaining non-adenomatous lesions, including all other types except SSA-like type, mostly showed mixed features and focal adenomatous dysplasia. KRAS mutation and p53 mutant-type expression were found in about half cases across all types, while PIK3CA mutation only in some of adenomatous and eosinophilic lesions and MLH1/PMS2 loss in a subset of adenomatous, mucinous and eosinophilic but not in differentiated and serrated lesions. SAT-B2 or PTEN loss and IMP3 overexpression were seen in a small subset of lesions. No BRAF, NRAS or EGFR gene mutation was detected in any type. Certain molecular-morphological correlations were demonstrated; however, no single or combined molecular alteration(s) was specific to any particular morphological type. CONCLUSIONS IBD-associated precancerous lesions are heterogeneous both histologically and molecularly. True colitis-associated adenomatous lesions are unlikely conventional adenomas. Non-adenomatous lesions without frank cytologic dysplasia should also be regarded as neoplastic.
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Affiliation(s)
- Xianyong Gui
- Pathology, University of Washington School of Medicine, Seattle, Washington, USA .,Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Martin Köbel
- Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jose Gp Ferraz
- Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Marietta Iacucci
- NIHR Biomedical Research Centre, Institute of Translational Medicine, University of Birmingham, Birmingham, Birmingham, UK
| | - Subrata Ghosh
- NIHR Biomedical Research Centre, Institute of Translational Medicine, University of Birmingham, Birmingham, Birmingham, UK
| | - Shuhong Liu
- Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Young Ou
- Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Marco Perizzolo
- Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Robert J Winkfein
- Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Peter Rambau
- Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Douglas J Demetrick
- Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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6
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Stjärngrim J, Ekbom A, Hammar U, Hultcrantz R, Forsberg AM. Rates and characteristics of postcolonoscopy colorectal cancer in the Swedish IBD population: what are the differences from a non-IBD population? Gut 2019; 68:1588-1596. [PMID: 30554159 DOI: 10.1136/gutjnl-2018-316651] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 11/23/2018] [Accepted: 11/25/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The rate of postcolonoscopy colorectal cancer (PCCRC) is considered a key quality indicator of colonoscopy; little is known about PCCRC in IBD. DESIGN A population-based cohort study of colonoscopies in Sweden from 2001 to 2010 was conducted. Individuals with a colorectal cancer (CRC) detected within 36 months after a colonoscopy were identified and stratified on UC, Crohn's disease (CD) or non-IBD. The CRCs were classified as detected CRCs (dCRC) (0-6 months) or as PCCRCs (6-36 months). PCCRC rates were calculated by the number of false negative/(the number of true positive+the number of false negative) colonoscopies. Poisson regression analysis was employed to examine the association between PCCRC and IBD (CD and UC) diagnosis, age, gender, location, time period and comorbidities. RESULTS We identified 348 232 colonoscopies in 270 918 individuals. Of these, 27 123 were performed on 14 597 individuals with CD, and 51 572 were performed on 26 513 individuals with UC. There were 13 317 CRCs in the non-IBD group, 133 in the CD group and 281 in the UC group. The PCCRC rate in the CD group was 28.3% and 41.0% in the UC group. The RR for a PCCRC was 3.82 (95% CI 2.94 to 4.96) in CD and 5.89 (95% CI 5.10 to 6.80) in UC, compared with non-IBD. The highest risk was observed among rectal cancer location in CD and in younger individuals with UC. CONCLUSION The high rates of PCCRC in young patients with UC and for rectal cancer location in CD might affect future performance of IBD surveillance.
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Affiliation(s)
- Jessica Stjärngrim
- Department of Medicine, Solna (MedS), Karolinska Institutet, Stockholm, Sweden
| | - Anders Ekbom
- Department of Medicine, Solna (MedS), Karolinska Institutet, Stockholm, Sweden
| | - Ulf Hammar
- Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
| | - Rolf Hultcrantz
- Department of Medicine, Solna (MedS), Karolinska Institutet, Stockholm, Sweden
| | - Anna M Forsberg
- Department of Medicine, Solna (MedS), Karolinska Institutet, Stockholm, Sweden
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7
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Kamarádová K, Vošmiková H, Rozkošová K, Ryška A, Tachecí I, Laco J. Non-conventional mucosal lesions (serrated epithelial change, villous hypermucinous change) are frequent in patients with inflammatory bowel disease—results of molecular and immunohistochemical single institutional study. Virchows Arch 2019; 476:231-241. [DOI: 10.1007/s00428-019-02627-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 12/13/2022]
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8
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Viso Vidal D, Sierra Ausín M, Suárez Álvarez P, Jorquera Plaza F. Serrated Lesions in patients with Inflammatory Bowel Disease. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2019; 111:400-402. [PMID: 30963771 DOI: 10.17235/reed.2019.5910/2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND a new serrated histologic finding has recently been discovered in patients with inflammatory bowel disease (IBD), known as serrated epithelial change (SEC). Recent studies suggest that SEC is strongly associated with dysplasia. CASE REPORT the case was a 62-year-old male in a dysplasia-colorectal cancer screening program with periodic chromoendoscopies, with CES findings in the previous chromoendoscopy studies. DISCUSSION a prophylactic colectomy seems a reasonable option for patients with several serrated lesions identified via chromoendoscopy screening. Particularly, if they are extensive and poorly defined, due to the possibility of developing high-grade dysplasia or colorectal cancer (CRC) during surveillance.
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Affiliation(s)
- David Viso Vidal
- aparato digestivo, Complejo Asistencial Universitario de León, españa
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9
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Svrcek M, Borralho Nunes P, Villanacci V, Beaugerie L, Rogler G, De Hertogh G, Tripathi M, Feakins R. Clinicopathological and Molecular Specificities of Inflammatory Bowel Disease-Related Colorectal Neoplastic Lesions: The Role of Inflammation. J Crohns Colitis 2018; 12:1486-1498. [PMID: 30202940 DOI: 10.1093/ecco-jcc/jjy132] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Compared with the general population, patients with inflammatory bowel disease [IBD] have an increased risk of developing colorectal cancer. Molecular mechanisms underlying colorectal carcinogenesis in the setting of IBD are not well understood. However, modern molecular investigative tools have facilitated the identification of features that help distinguish IBD-related carcinoma from sporadic carcinoma. Moreover, with advances in endoscopic technology and improved understanding of the natural history, the management of colorectal neoplastic lesions in IBD patients has evolved. This review discusses the clinicopathological and molecular features of colorectal neoplastic lesions complicating IBD. Chronic inflammation is believed to promote the development of neoplasia, partly by producing reactive oxygen and nitrogen species [ROS and NOS], which may interact with genes involved in carcinogenetic pathways. Furthermore, alterations in microbiota and in the innate and adaptive immune responses might contribute to this process, particularly by initiating, regulating, and sustaining chronic inflammation. Earlier detection and better characterization of neoplastic colorectal lesions complicating IBD and a better knowledge of the molecular mechanisms underlying carcinogenesis in this setting should facilitate improvements in the risk stratification of patients with longstanding IBD and in the management of dysplastic and malignant colorectal lesions that arise in this setting.
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Affiliation(s)
- Magali Svrcek
- Department of Pathology, AP-HP, Hôpitaux Universitaires Est Parisien, Hôpital Saint-Antoine, Paris, France.,Sorbonne-Université, Université Pierre et Marie Curie - Paris 6, Paris, France
| | - Paula Borralho Nunes
- Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal & Serviço de Anatomia Patológica, Hospital Cuf Descobertas, Rua Mário Botas Lisbon, Portugal
| | | | - Laurent Beaugerie
- Sorbonne-Université, Université Pierre et Marie Curie - Paris 6, Paris, France.,Department of Gastroenterology, AP-HP, Hôpitaux Universitaires Est Parisien, Hôpital Saint-Antoine, Paris, France
| | - Gerhard Rogler
- Department of Gastroenterology and Hepatology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Gert De Hertogh
- Department of Pathology, University Hospital Leuven, Leuven, Belgium
| | - Monika Tripathi
- Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Roger Feakins
- Department of Cellular Pathology, Barts Health NHS Trust, London, UK
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