Background: Patients with ulcerative colitis and Crohn's colitis have increased risk of colorectal cancer. Current screening endoscopy protocols based on white light endoscopy (WLE) and random biopsies are laborious and of uncertain sensitivity. Novel endoscopic techniques include chromoendoscopy (CE) and confocal laser endomicroscopy (CLE).
Aim: The aim was to compare WLE and CE for the detection of intraepithelial neoplasia (IEN). Furthermore, we analysed the sensitivity and specificity of CE and CLE for the diagnosis of IEN.
Methods: The cohort consisted of 30 patients examined by WLE, CE with 0.4% indigocarmine, and by a CLE system Pentax EC-3870CIFK during one examination. Additional 15 patients were examined by conventional protocol only. Random biopsies and biopsies from all suspicious lesions were taken. We compared the number of IENs detected by WLE and CE and analysed the predictive values of CE and CLE for the histology diagnosis.
Results: There were 1584 random biopsies (35.2 per patient) taken. There were 78 targeted biopsies (1.7 per patient) taken in 24 of 45 patients examined by WLE and an additional 36 biopsies in 16 of 30 patients examined by CE (1.17 additional per patient). There were no IENs found on random biopsies versus six low-grade or high-grade IENs in four patients (two detected by WLE, four additional by CE) from targeted biopsies, P=0.02. A total of 100 suspicious lesions were detected and analysed by CE and histology. CLE could not examine 32 of 100 lesions (two of 30 flat vs. 30 of 70 pedunculated lesions, P=0.0002, odds ratio 10.5). The sensitivity of CE/CLE for low-grade or high-grade IEN was 100/100%, the specificity 96.8/98.4%, positive predictive value was 62.5/66.7% and negative predictive value was 100/100%.
Conclusion: Targeted biopsies are superior to random biopsies in the screening of IEN in patients with inflammatory bowel disease. CE increases the diagnostic yield of WLE. In our study CLE did not provide additional clinical benefits.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/MEG.0b013e32834791b4 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The efficacy and safety of suvemcitug, envafolimab, and FOLFIRI in microsatellite-stable or mismatch repair-proficient colorectal cancer: preliminary results of a phase 2 study.
Int J Colorectal Dis
January 2025
Internal Medicine, Jilin Cancer Hospital, Changchun, China.
Purpose: This phase II study is designed to evaluate the combination therapy involving suvemcitug and envafolimab with FOLFIRI in microsatellite-stable or mismatch repair-proficient (MSS/pMMR) colorectal cancer (CRC) in the second-line treatment setting.
Methods: This study is a non-randomized, open-label prospective study comprising multiple cohorts (NCT05148195). Here, we only report the data from the CRC cohort.
Prospective Validation of an Automated Hybrid Multidimensional MRI Tool for Prostate Cancer Detection Using Targeted Biopsy: Comparison with PI-RADS-based Assessment.
Radiol Imaging Cancer
January 2025
From the Department of Radiology (A.C., A.N.Y., R.E., C.H., G.L., M.M., E.B.J., A.L.C., B.G., G.S.K., A.O.), Sanford J. Grossman Center of Excellence in Prostate Imaging and Image Guided Therapy (A.C., A.N.Y., M.M., A.L.C., B.G.), Department of Surgery, Section of Urology (G.G., L.F.R., P.K.M., S.E.), Department of Pathology (T.A.), and Department of Public Health Sciences (M.G.), University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637.
Purpose To evaluate the use of an automated hybrid multidimensional MRI (HM-MRI)-based tool to prospectively identify prostate cancer targets before MRI/US fusion biopsy in comparison with Prostate Imaging and Reporting Data System (PI-RADS)-based multiparametric MRI (mpMRI) evaluation by expert radiologists. Materials and Methods In this prospective clinical trial (ClinicalTrials.gov registration no.
View Article and Find Full Text PDFComparison of postoperative analgesic efficacy between erector spinae plane block and rhomboid intercostal block in breast-conserving surgery and sentinel lymph node biopsy: A randomized non-inferiority clinical trial.
Agri
January 2025
Department of Anesthesiology and Reanimation, İstanbul Medipol University Faculty of Medicine, İstanbul, Türkiye.
Objectives: Breast-conserving surgery is a common breast operation type in the world. Patients may feel severe postoperative pain after the surgery. Several regional anesthesia methods are used for postoperative pain control as a part of multimodal analgesia management after breast surgery.
View Article and Find Full Text PDFShatavari supplementation during eight weeks of resistance training increases training load, enhances skeletal muscle contractility and alters the skeletal muscle proteome in older women.
Front Nutr
January 2025
Faculty of Health and Life Sciences, Department of Public Health and Sport Sciences, University of Exeter, Exeter, United Kingdom.
Introduction: Shatavari is a herbal dietary supplement that may increase skeletal muscle strength in younger and older adults. Shatavari contains compounds with both estradiol-like and antioxidant properties, which could enhance muscle function. Postmenopausal women may derive the greatest benefit, as estrogen deficiency adversely impacts skeletal muscle function.
View Article and Find Full Text PDFNanopore-based random genomic sampling for intraoperative molecular diagnosis.
Genome Med
January 2025
Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, 03756, USA.
Background: Central nervous system tumors are among the most lethal types of cancer. A critical factor for tailored neurosurgical resection strategies depends on specific tumor types. However, it is uncommon to have a preoperative tumor diagnosis, and intraoperative morphology-based diagnosis remains challenging.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!