Implications of Precancerous Rectal Biopsy in Patients With Inflammatory Bowel Disease

Gewertz, Bruce L.; Dent, T.; Appelman, Henry D.

doi:10.1001/archsurg.1976.01360220022003

Cited by 19 publications

(2 citation statements)

References 15 publications

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“…Premalignant changes were found in seven of these, and in five a carcinoma was found in the resected specimen, being unsuspected in four. Other studies (Lennard-Jones et al, 1974;Yardley and Keren, 1974;Cook and Goligher, 1975;Issacson, 1976;Gewertz et al, 1976;Lennard-Jones et al, 1977) have confirmed that premalignant changes are not always accompanied by carcinoma, although most carcinomas are accompanied by precancer which is frequently rectal. Several of these studies have also suggested that rectal precancer may not always be present or may be patchy.…”

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confidence: 88%

Value of sigmoidoscopy and biopsy in detection of carcinoma and premalignant change in ulcerative colitis

Riddell¹,

Morson²

1979

Gut

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Careful sigmoidoscopy and multiple biopsies in this study had potential value as an aid in the detection of 85-90 % of all carcinomas. In practice the figure would almost certainly be lower due to intrinsic bias (see discussion) so that, although regular sigmoidoscopy and biopsy would be of great value when colonoscopy is not available, the latter should be included in any long-term programme of carcinoma prevention.The prevention of carcinoma complicating ulcerative colitis depends on the identification and close follow-up of that subgroup of colitic patients known to be particularly predisposed to the development of carcinoma. These are patients with extensive or total colitis, particularly if the age of onset was before 25 years of age, and with a long history of disease, traditionally 10 years, despite the fact that 20% of all colitic cancers occur before this time (Mottet, 1971). Follow-up of this high risk group has created problems of management, which varies from proctocolectomy when total disease has been present for 10 years, through varying degrees of surveillance, to the taking of no particular precaution in view of the relative rarity of carcinoma as a complication of ulcerative colitis. Mottet (1971), combining several series, concluded that approximately 3 0-3.5% of all colitics will eventually 'Present address:

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confidence: 88%

Value of sigmoidoscopy and biopsy in detection of carcinoma and premalignant change in ulcerative colitis

Riddell¹,

Morson²

1979

Gut

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“…It has been reported that harboring carcinoma in patients with UC has almost uniformly disclosed the presence of dysplasia as well, either adjacent to or remote from the carcinomas. [10][11][12][13][14][15][16] A report of the examination of resected specimens from 240 IBD patients (64 Crohn's disease and 176 UC) with colorectal cancer revealed synchronous dysplasia in 48% of patients and synchronous cancer in 12%. 17 Remote dysplasia was detected at a distance from the colonic cancer with UC in 72% of the patients.…”

Section: Overview Of Colorectal Neoplasiamentioning

confidence: 99%

Management of Pouch Neoplasia

Sugita

Koganei

Takagi

2022

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Pouch neoplasia occurs following ileal pouch-anal anastomosis, with or without mucosectomy in ulcerative colitis and familiar adenomatous polyposis.OBJECTIVES: This study aimed to review available literature and make recommendations regarding pouch neoplasia.DATA SOURCES: Data were collected from specialty hospitals, and a literature review was conducted due to the lack of published large-scale studies. Recommendations for treatment were made based on the literature review and expert opinions.STUDY SELECTION: Large-scale studies of pouch neoplasia were selected. INTERVENTION:The intervention was studies with details of pouch neoplasia. MAIN OUTCOME MEASURES:We aimed to identify the management modalities for pouch neoplasia based on the type. RESULTS:Pouch neoplasia can occur in each component of the pouch-afferent limb, pouch body, cuff, and anal transitional zone. In patients with ulcerative colitis, pouch neoplasia is treated because colitis-associated neoplasia comprises a multifocal lesion, which most commonly involves the cuff and anal transitional zone.Close surveillance or endoscopic complete resection is optimal for low-grade dysplasia. For adenocarcinoma, high-grade dysplasia, and low-grade dysplasia with difficult complete resection, pouch excision is recommended. In familiar adenomatous polyposis patients with adenomas of the afferent limb or pouch body, endoscopic resection is optimal. Endoscopic resection is feasible for discrete adenoma in the cuff and anal transitional zone, and surgical excision is optimal for laterally spreading, extensive, large, or flat adenoma. For adenocarcinomas involving any component, pouch excision is recommended.LIMITATIONS: Published large-scale studies were lacking because of disease rarity.CONCLUSION: Pouch neoplasia occurs in each pouch component. In patients with ulcerative colitis, pouch excision is recommended for adenocarcinomas and high-grade dysplasia, whereas endoscopic intervention may be preferable to low-grade dysplasia. In familiar adenomatous polyposis patients, pouch excision is necessary for adenocarcinoma, and endoscopic resection or excisional surgery is optimal for adenoma.

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The pattern of cell proliferation in neoplastic and nonneoplastic lesions of ulcerative colitis

Noffsinger

Miller

Cusi

et al. 1996

Cancer

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Cell proliferation is markedly increased in patients with UC, and appears abnormally regulated in neoplastic lesions. Furthermore, Ki-67 staining helps delineate areas of dysplasia in cases in which the distinction from regenerative mucosa is unclear. The increased cell proliferation that occurs in patients with UC may predispose the mucosa to mutational events, thereby increasing cancer risk in these patients.

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Implications of Precancerous Rectal Biopsy in Patients With Inflammatory Bowel Disease

Cited by 19 publications

References 15 publications

Value of sigmoidoscopy and biopsy in detection of carcinoma and premalignant change in ulcerative colitis

Value of sigmoidoscopy and biopsy in detection of carcinoma and premalignant change in ulcerative colitis

Management of Pouch Neoplasia

The pattern of cell proliferation in neoplastic and nonneoplastic lesions of ulcerative colitis

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