Are random biopsies still useful for the detection of neoplasia in patients with IBD undergoing surveillance colonoscopy with chromoendoscopy?

Moussata, Driffa; Allez, Matthieu; Cazals–Hatem, Dominique; Tréton, Xavier; Laharie, David; Reimund, Jean‐Marie; Bertheau, Philippe; Bourreille, Arnaud; Lavergne‐Slove, Anne; Brixi, Hédia; Branche, Julien; Gornet, Jean–Marc; Stefănescu, Carmen; Moreau, Jacques; Marteau, Philippe; Pelletier, Anne-Laure; Carbonnel, Franck; Seksik, Philippe; Simon, M.; Fléjou, Jean‐François; Colombel, Jean–Frédéric; Charlois, Anne-Laure; Roblin, Xavier; Nancey, Stéphane; Bouhnik, Yoram; Berger, Françoise; Flourié, Bernard

doi:10.1136/gutjnl-2016-311892

Cited by 74 publications

(105 citation statements)

References 35 publications

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“…In the SCENIC meta-analysis, eight studies were identified used DCE compared with WLE alone and revealed a significantly greater proportion of patients with dysplasia by using DCE (relative risk (RR)=1.8 (95%CI 1.2 to 2.6) and absolute risk increase of 6% (95% CI 3% to 9%)) 4 35 37–40. Based on a real-life study, random biopsies should still be considered in association with DCE in patients with IBD with a personal history of neoplasia, concomitant PSC or a tubular colon during colonoscopy 41. In SCENIC consensus unanimous agreement could not be reached on this question, although 80% of the panellists favoured targeted biopsies only.…”

Section: Applications Of New Technologies That Are Available In Ibdmentioning

confidence: 99%

Advanced endoscopic techniques in the assessment of inflammatory bowel disease: new technology, new era

Iacucci

Furfaro

Matsumoto

et al. 2018

Gut

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Endoscopic assessment of inflammation and mucosal healing is crucial for appropriate management in IBD. Current definition of endoscopic mucosal healing has been derived using previous generation of standard white light endoscopes. New endoscopy technologies widely available provide much more detailed images of mucosal and vascular patterns. Novel endoscopic techniques with high definition image, optical and digital enhancement have enhanced the quality and fine details of vascular and mucosal pattern so that endoscopic images have started to reflect histological changes for lesions and inflammation/healing. These technologies can now define subtle inflammatory changes and increase detection and characterisation of colonic lesions in patients with IBD. The best endoscopic technique to detect dysplasia in IBD is still debated. Dye chromoendoscopy with targeted biopsies is considered by Surveillance for Colorectal Endoscopic Neoplasia Detection and Management in inflammatory Bowel Disease Patients: International Consensus Recommendations (SCENIC consensus the standard of care and recommended for adoption by gastroenterologists in practice. In future, it is possible that well-trained colonoscopists using high definition equipment with image enhancements may be able to obtain equivalent yield without pan-colonic dye spraying and characterise lesions. Finally, SCENIC introduced endoscopic resectability of some dysplastic colonic lesions—new techniques may now better characterise endoscopic resectability and limit the number of colectomies. In this review, we will provide a state-of-the-art opinion on the direction of technological advances in the assessment of IBD and how new concepts will refine clinical practice.

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Section: Applications Of New Technologies That Are Available In Ibdmentioning

confidence: 99%

Advanced endoscopic techniques in the assessment of inflammatory bowel disease: new technology, new era

Iacucci

Furfaro

Matsumoto

et al. 2018

Gut

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“…Cancer mortality rates were estimated from the National Cancer Intelligence Network Web site, which reports 5-year survival for Dukes stages A/B/C/D. 12 Cancers were assumed to be split evenly across Dukes A and B, and so the mean of the rates for Dukes A and B was used.…”

Section: Derivation Of Transition Probabilitiesmentioning

confidence: 99%

“…8,10,11 Although the use of chromoendoscopy may reduce the rate of endoscopically invisible dysplasia, dysplasia detected by random biopsies can still occur at an appreciable rate (12.8% of all dysplasia detected perpatient) in community-based studies of chromoendoscopy. 12 Several factors must be evaluated in the decision-making process: estimates of the risk of developing a more advanced lesion or CRC after a finding of endoscopically invisible LGD vary, the patient may have undiagnosed concurrent CRC, and the risk associated with surgery depends on both age and comorbidities. Two meta-analyses have considered the risk of developing cancer after a finding of endoscopically invisible dysplasia.…”

mentioning

confidence: 99%

Surgery versus surveillance in ulcerative colitis patients with endoscopically invisible low-grade dysplasia: a cost-effectiveness analysis

Parker

Buchanan

Wordsworth

et al. 2017

Gastrointestinal Endoscopy

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“…In a prospective study of 1000 patients with IBD undergoing surveillance in France, Moussata et al 40 evaluated chromoendoscopy with random biopsies and demonstrated that chromoendoscopy with targeted biopsies detected the majority of patients with dysplasia, and only 15% of patients with neoplasia were identified from random biopsies. Detection of neoplasia in random biopsy was associated with a personal history of neoplasia, tubular appearing colon, and presence of primary sclerosing cholangitis.…”

Section: Random Versus Targeted Biopsiesmentioning

confidence: 99%

Endoscopic Surveillance in Long-standing Colitis

Boland

Shergill

Kaltenbach

2017

Curr Treat Options Gastro

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There is a relative increase in the risk of colon cancer in patients with inflammatory bowel disease (IBD) affecting the colon, and endoscopic surveillance is advocated to mitigate this risk. The current standard practice is to survey this high-risk patient population using colonoscopy. Chromoendoscopy with targeted biopsies has emerged as the colonoscopy modality recommended by the major societies to optimize dysplasia detection. Studies over the past year support the improved yield from targeted as compared to random biopsies and improved dysplasia detection from chromoendoscopy as compared to white light endoscopy. Ongoing efforts should focus on the implementation of chromoendoscopy as the primary modality for colorectal cancer surveillance in IBD. Our review will describe current status and provide an update on the recent literature on surveillance colonoscopy in patients with IBD.

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Are random biopsies still useful for the detection of neoplasia in patients with IBD undergoing surveillance colonoscopy with chromoendoscopy?

Abstract: IRB 001508, Paris 7 University.

Cited by 74 publications

References 35 publications

Advanced endoscopic techniques in the assessment of inflammatory bowel disease: new technology, new era

Advanced endoscopic techniques in the assessment of inflammatory bowel disease: new technology, new era

Surgery versus surveillance in ulcerative colitis patients with endoscopically invisible low-grade dysplasia: a cost-effectiveness analysis

Endoscopic Surveillance in Long-standing Colitis

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