Adenomas in Patients with Inflammatory Bowel Disease Are Associated with an Increased Risk of Advanced Neoplasia

Schaik, Fiona D.M. van; Mooiweer, Erik; Have, Mike van der; Belderbos, Tim D.; Kate, Fiebo J.W. ten; Offerhaus, G. Johan A.; Schipper, Marguérite E.I.; Dijkstra, Gerard; Pierik, Marieke; Stokkers, Pieter; Ponsioen, Cyriel Y.; Jong, Dirk J. de; Hommes, Daniël W.; Bodegraven, Ad A. van; Siersema, Peter D.; Oijen, Martijn G.H. van; Oldenburg, Bas

doi:10.1097/mib.0b013e318286f771

Cited by 22 publications

(16 citation statements)

References 22 publications

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“…Indeed, chronic inflammation has been closely linked with preneoplastic lesions, for example, dysplasia-associated lesions in chronic ulcerative colitis. (17)(18)(19) A similar relationship between chronic inflammation (chronic pancreatitis) and dysplasia (PanIN) could also be suggested in the pancreas from our data.…”

Section: Discussionsupporting

confidence: 85%

“…Chronic inflammation may also play a role in facilitating or accelerating tumorigenesis, through additional genetic events such as tumor suppressor gene mutation and oncogenic mutations. Indeed, chronic inflammation has been closely linked with preneoplastic lesions, for example, dysplasia‐associated lesions in chronic ulcerative colitis . A similar relationship between chronic inflammation (chronic pancreatitis) and dysplasia (PanIN) could also be suggested in the pancreas from our data.…”

Section: Discussionsupporting

confidence: 78%

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Presence of pancreatic intraepithelial neoplasia‐3 in a background of chronic pancreatitis in pancreatic cancer patients

et al. 2015

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The clinical significance of pancreatic intraepithelial neoplasia (PanIN) lesions in non-neoplastic pancreata of pancreatic ductal adenocarcinoma (PDAC) patients remains controversial. As chronic inflammation has been recently demonstrated to promote dissemination of in situ precancerous lesions, we investigated the prognostic significance of PanINs associated with chronic pancreatitis (CP) in PDAC patients. This retrospective study analyzed 125 curatively resected PDAC specimens for the presence of PanIN and CP. Univariate and multivariate analyses were performed to identify significant predictive factors for poor disease-free survival (DFS) and overall survival (OS). Immunohistochemical staining for E-cadherin and S100A4, markers of epithelial-mesenchymal transition, was performed on resected specimens containing PanIN-3 lesions. CP was observed in 27.2% (34/125) and PanIN-3 in 25.6% (32/125) of specimens. In the presence of CP, PanIN-3 was significantly associated with decreased survival (DFS: 4.3 vs 15.5 months, P = 0.021; OS: 16.3 vs 30.9 months, P = 0.004). PanIN-3 was not a prognostic factor in the absence of CP. The presence of both PanIN-3 and CP was associated with a reduced survival compared to the other cases, in both univariate (DFS: P = 0.039; OS: P = 0.023) and multivariate (DFS: P = 0.020; OS: P = 0.076) analyses. Furthermore, E-cadherin loss and S100A4 expression were more frequently observed in PanIN-3 lesions of CP specimens than in those of non-CP specimens, although not statistically significant. PanIN-3 in association with CP is a significant prognostic factor for decreased survival in PDAC patients, suggesting that chronic inflammation may accelerate the progression of preinvasive high-grade PanIN.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 78%

Presence of pancreatic intraepithelial neoplasia‐3 in a background of chronic pancreatitis in pancreatic cancer patients

et al. 2015

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“…Our results are therefore similar to that by the Mayo group who found that the 5-year cumulative risk of subsequent colonic neoplasia after endoscopic resection in both those with sporadic adenomas as well as those with adenoma like masses to be 68.5% and 70.6% respectively 9 . A Dutch pathology database study showed that the adjusted risk of developing advanced neoplasia on follow up for patients with IBD and adenomas compared to IBD patients without adenomas was 2.8 fold higher (95% CI 1.0-8.2) which is also similar to the results of the present study 14 . A systematic review which included 10 studies, with 376 IBD patients with resected polypoid dysplasia followed up for a mean of 54 months, reported an pooled incidence for dysplasia and CRC of 65 and 5.3 cases per 1000 patient years respectively 11 .…”

Section: Discussionsupporting

confidence: 82%

“…Risks of cancer in patients with UC are therefore best expressed on the basis of duration of disease and adjusted for risk factors. A Dutch pathology database (PALGA) study showed that the adjusted risk of developing advanced neoplasia on follow up for patients with IBD and adenomas compared to IBD patients without adenomas was 2.8 fold higher (95% CI 1.0-8.2) underscoring the need for intensive surveillance following endoscopic resection 14 .…”

Section: Introductionmentioning

confidence: 99%

Patients with Endoscopically Visible Polypoid Adenomatous Lesions Within the Extent of Ulcerative Colitis Have an Increased Risk of Colorectal Cancer Despite Endoscopic Resection

et al. 2016

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Objectives: Ulcerative colitis (UC) is associated with an increased risk of colorectal cancer (CRC). Few studies have looked at long term outcomes of endoscopically visible adenomatous lesions removed by endoscopic resection in these patients. We aimed to assess the risk of developing CRC in UC patients with adenomatous lesions that develop within the segment of colitis compared to the remainder of an ulcerative colitis cohort. Conclusions: The risk of developing CRC is significantly higher in UC patients with polypoid adenomatous lesions, within the extent of inflammation, despite endoscopic resection. Patients and physicians should take the increased risk into consideration during follow up of these patients.

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“…IBD has been associated with CRC in several epidemiologic studies (4)(5)(6). Allopurinol has been shown to be associated with lower risk of CRC in subjects with gout (7) and with better survival in advanced CRC (8,9).…”

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confidence: 99%

Allopurinol in Subjects with Colorectal Adenoma—Response

Puntoni

DeCensi

2013

Cancer Prevention Research

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Adenomas in Patients with Inflammatory Bowel Disease Are Associated with an Increased Risk of Advanced Neoplasia

Cited by 22 publications

References 22 publications

Presence of pancreatic intraepithelial neoplasia‐3 in a background of chronic pancreatitis in pancreatic cancer patients

Presence of pancreatic intraepithelial neoplasia‐3 in a background of chronic pancreatitis in pancreatic cancer patients

Patients with Endoscopically Visible Polypoid Adenomatous Lesions Within the Extent of Ulcerative Colitis Have an Increased Risk of Colorectal Cancer Despite Endoscopic Resection

Allopurinol in Subjects with Colorectal Adenoma—Response

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