PDF herunterladen
CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(11): E1285-E1294
DOI: 10.1055/a-2437-8102
Original article

Dye-based chromoendoscopy detects more neoplasia than white light endoscopy in patients with primary sclerosing cholangitis and IBD

Rodrigo V Motta‡
1   Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6396)
,
Vipin Gupta‡
2   Department of Gastroenterology, North Bristol NHS Trust, Bristol, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN1982)
,
Karen Hartery
3   Department of Gastroenterology, St James's Hospital, Dublin, Ireland (Ringgold ID: RIN58024)
,
Paul Bassett
4   Statistics, Statsconsultancy Ltd, Buckinghamshire, United Kingdom of Great Britain and Northern Ireland
,
Simon J Leedham
5   Gastrointestinal Stem Cell Biology Lab, Wellcome Centre Human Genetics, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6396)
,
Roger W Chapman
1   Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6396)
,
Simon PL Travis
6   Translational Gastroenterology and Liver Unit, Nuffield Department of Medicine and, Kennedy Institute of Rheumatology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6396)
,
Emma L Culver   *
1   Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6396)
,
James E. East   *
1   Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6396)
› InstitutsangabenGefördert durch: NIHR Oxford Biomedical Research Centre
Gefördert durch: Cancer Research UK 25901
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Background and study aims Patients with primary sclerosing cholangitis and inflammatory bowel disease (IBD) have a high risk of colorectal cancer. There is no agreement on the best technique for surveillance for colorectal neoplasia. We aimed to assess whether chromoendoscopy and/or high-definition endoscopy is associated with increased detection of neoplasia in patients with primary sclerosing cholangitis undergoing surveillance compared with when they were not used.

Patients and methods This was a single-center, retrospective, observational study designed to analyze differences in the detection of neoplasia (adenomatous and serrated) among patients with primary sclerosing cholangitis and IBD who underwent annual surveillance between 2010 and 2020. Multilevel logistic regression was used to adjust for confounders.

Results Ninety-one patients were identified, resulting in 359 colonoscopies with 360 person-years of follow up. Over the study period, 22 of 91 patients (24%) had at least one neoplastic lesion identified; however, the mean neoplastic lesion rate was 0.87 (54/63) for the primary sclerosing cholangitis-ulcerative colitis subgroup compared with 0.24 (4/17) for the primary sclerosing cholangitis-Crohn’s disease subgroup. Chromoendoscopy was associated with a significantly higher detection rate for neoplasia (odds ratio [OR] 5.58, 95% confidence interval [CI] 2.08–14.9,P=0.001), and this association remained after adjusting for confounders, including high-definition endoscopy. High-definition endoscopes had a higher rate of neoplasia detection, but the significance was lost after adjustment for confounders, including chromoendoscopy (OR 1.93, 95% CI 0.69–5.40, P=0.21).

Conclusions Chromoendoscopy is associated with a higher detection rate for neoplasia in patients with primary sclerosing cholangitis and IBD even with high-definition colonoscopes.

Keywords

Endoscopy Lower GI Tract - Inflammatory bowel disease - CRC screening - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE...)

* These authors share senior authorship.


Supplementary Material



Publikationsverlauf

Eingereicht: 10. März 2024

Angenommen nach Revision: 30. Juli 2024

Artikel online veröffentlicht:
11. November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Leserbrief zu diesem Artikel:

Surveillance colonoscopy in PSC-IBD: Some answers but more questions remainEndosc Int Open 2025; 13(CP):
DOI: 10.1055/a-2514-9742

Bibliographical Record
Rodrigo V Motta, Vipin Gupta, Karen Hartery, Paul Bassett, Simon J Leedham, Roger W Chapman, Simon PL Travis, Emma L Culver, James E. East. Dye-based chromoendoscopy detects more neoplasia than white light endoscopy in patients with primary sclerosing cholangitis and IBD. Endosc Int Open 2024; 12.
DOI: 10.1055/a-2437-8102
 

  • References

  • 1 Zheng H-H, Jiang X-L. Increased risk of colorectal neoplasia in patients with primary sclerosing cholangitis and inflammatory bowel disease: a meta-analysis of 16 observational studies. Eur J Gastroenterol Hepatol 2016; 28: 383-390
    CrossrefPubMedSuche in Google Scholar
  • 2 Selinger CP, Andrews JM, Titman A. et al. Long-term follow-up reveals low incidence of colorectal cancer, but frequent need for resection, among Australian patients with inflammatory bowel disease. Clin Gastroenterol Hepatol 2014; 12: 644-650
    CrossrefPubMedSuche in Google Scholar
  • 3 Lutgens MWMD, van Oijen MGH, van der Heijden GJMG. et al. Declining risk of colorectal cancer in inflammatory bowel disease: an updated meta-analysis of population-based cohort studies. Inflamm Bowel Dis 2013; 19: 789-799
    CrossrefPubMedSuche in Google Scholar
  • 4 Eaden JA, Abrams KR, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut 2001; 48: 526-535
    CrossrefPubMedSuche in Google Scholar
  • 5 Jess T, Simonsen J, Jørgensen KT. et al. Decreasing risk of colorectal cancer in patients with inflammatory bowel disease over 30 years. Gastroenterology 2012; 143: 375-81.e1 quiz e13–4
    CrossrefPubMedSuche in Google Scholar
  • 6 Molodecky NA, Kareemi H, Parab R. et al. Incidence of primary sclerosing cholangitis: a systematic review and meta-analysis. Hepatology 2011; 53: 1590-1599
    CrossrefPubMedSuche in Google Scholar
  • 7 Olén O, Erichsen R, Sachs MC. et al. Colorectal cancer in ulcerative colitis: a Scandinavian population-based cohort study. Lancet 2020; 395: 123-131
    CrossrefPubMedSuche in Google Scholar
  • 8 de Vries AB, Janse M, Blokzijl H. et al. Distinctive inflammatory bowel disease phenotype in primary sclerosing cholangitis. World J Gastroenterol 2015; 21: 1956-1971
    CrossrefPubMedSuche in Google Scholar
  • 9 Palmela C, Peerani F, Castaneda D. et al. Inflammatory bowel disease and primary sclerosing cholangitis: A review of the phenotype and associated specific features. Gut Liver 2018; 12: 17-29
    CrossrefPubMedSuche in Google Scholar
  • 10 Halliday JS, Djordjevic J, Lust M. et al. A unique clinical phenotype of primary sclerosing cholangitis associated with Crohn’s disease. J Crohns Colitis 2012; 6: 174-181
    CrossrefPubMedSuche in Google Scholar
  • 11 Braden B, Halliday J, Aryasingha S. et al. Risk for colorectal neoplasia in patients with colonic Crohn’s disease and concomitant primary sclerosing cholangitis. Clin Gastroenterol Hepatol 2012; 10: 303-308
    CrossrefPubMedSuche in Google Scholar
  • 12 Zheng H-H, Jiang X-L. Increased risk of colorectal neoplasia in patients with primary sclerosing cholangitis and inflammatory bowel disease: a meta-analysis of 16 observational studies. Eur J Gastroenterol Hepatol 2016; 28: 383-390
    CrossrefPubMedSuche in Google Scholar
  • 13 Choi W-T, Yozu M, Miller GC. et al. Nonconventional dysplasia in patients with inflammatory bowel disease and colorectal carcinoma: a multicenter clinicopathologic study. Mod Pathol 2020; 33: 933-943
    CrossrefPubMedSuche in Google Scholar
  • 14 Zhang R, Lauwers GY, Choi W-T. Increased risk of non-conventional and invisible dysplasias in patients with primary sclerosing cholangitis and inflammatory bowel disease. J Crohns Colitis 2022; 16: 1825-1834
    CrossrefPubMedSuche in Google Scholar
  • 15 Shah SC, Ten Hove JR, Castaneda D. et al. High risk of advanced colorectal neoplasia in patients with primary sclerosing cholangitis associated with inflammatory bowel disease. Clin Gastroenterol Hepatol 2018; 16: 1106-1113.e3
    CrossrefPubMedSuche in Google Scholar
  • 16 Hu AB, Burke KE, Kochar B. et al. Yield of random biopsies during colonoscopies in inflammatory bowel disease patients undergoing dysplasia surveillance. Inflamm Bowel Dis 2021; 27: 779-786
    CrossrefPubMedSuche in Google Scholar
  • 17 O’Brien MJ, Yang S, Mack C. et al. Comparison of microsatellite instability, CpG island methylation phenotype, BRAF and KRAS status in serrated polyps and traditional adenomas indicates separate pathways to distinct colorectal carcinoma end points. Am J Surg Pathol 2006; 30: 1491-1501
    CrossrefPubMedSuche in Google Scholar
  • 18 Maaser C, Sturm A, Vavricka SR. et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis 2019; 13: 144-164
    CrossrefPubMedSuche in Google Scholar
  • 19 Lichtenstein GR, Loftus E V, Isaacs KL. et al. ACG Clinical Guideline: Management of Crohn’s Disease in Adults. Am J Gastroenterol 2018; 113: 481-517
    CrossrefPubMedSuche in Google Scholar
  • 20 Rubin DT, Ananthakrishnan AN, Siegel CA. et al. ACG Clinical Guideline: Ulcerative Colitis in Adults. Am J Gastroenterol 2019; 114: 384-413
    CrossrefPubMedSuche in Google Scholar
  • 21 Bisschops R, East JE, Hassan C. et al. Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline-Update 2019. Endoscopy 2019; 51: 1155-1179
    Thieme ConnectPubMedSuche in Google Scholar
  • 22 Cairns SR, Scholefield JH, Steele RJ. et al. Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002). Gut 2010; 59: 666-689
    CrossrefPubMedSuche in Google Scholar
  • 23 Feuerstein JD, Rakowsky S, Sattler L. et al. Meta-analysis of dye-based chromoendoscopy compared with standard- and high-definition white-light endoscopy in patients with inflammatory bowel disease at increased risk of colon cancer. Gastrointest Endosc 2019; 90: 186-195.e1
    CrossrefPubMedSuche in Google Scholar
  • 24 Rutter MD, East J, Rees CJ. et al. British Society of Gastroenterology/Association of Coloproctology of Great Britain and Ireland/Public Health England post-polypectomy and post-colorectal cancer resection surveillance guidelines. Gut 2020; 69: 201-223
    CrossrefPubMedSuche in Google Scholar
  • 25 von Elm E, Altman DG, Egger M. et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med 2007; 147: 573-577
    CrossrefPubMedSuche in Google Scholar
  • 26 Smith SCL, Cannatelli R, Bazarova A. et al. Performance measures in inflammatory bowel disease surveillance colonoscopy: Implementing changes to practice improves performance. Dig Endosc 2020; 32: 592-599
    CrossrefPubMedSuche in Google Scholar
  • 27 Houwen BBSL, Hassan C, Coupé VMH. et al. Definition of competence standards for optical diagnosis of diminutive colorectal polyps: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2022; 54: 88-99
    Thieme ConnectPubMedSuche in Google Scholar
  • 28 Imperatore N, Castiglione F, Testa A. et al. Augmented Endoscopy for Surveillance of Colonic Inflammatory Bowel Disease: Systematic Review With Network Meta-analysis. J Crohns Colitis 2019; 13: 714-724
    CrossrefPubMedSuche in Google Scholar
  • 29 Iacucci M, Hassan C, Fort Gasia M. et al. Serrated adenoma prevalence in inflammatory bowel disease surveillance colonoscopy, and characteristics revealed by chromoendoscopy and virtual chromoendoscopy. Can J Gastroenterol Hepatol 2014; 28: 589-594
    CrossrefPubMedSuche in Google Scholar
  • 30 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.
    PubMed
  • 31 Fung BM, Lindor KD, Tabibian JH. Cancer risk in primary sclerosing cholangitis: Epidemiology, prevention, and surveillance strategies. World J Gastroenterol 2019; 25: 659-671
    CrossrefPubMedSuche in Google Scholar
  • 32 de Jong ME, Nagtegaal ID, Vos S. et al. Increased colorectal neoplasia risk in patients with inflammatory bowel disease and serrated polyps with dysplasia. Dig Dis Sci 2022; 67: 5647-5656
    CrossrefPubMedSuche in Google Scholar
  • 33 Harpaz N, Goldblum JR, Shepherd NA. et al. Colorectal dysplasia in chronic inflammatory bowel disease: A contemporary consensus classification and interobserver study. Hum Pathol 2023; 138: 49-61
    CrossrefPubMedSuche in Google Scholar
  • 34 Rabinowitz LG, Kumta NA, Marion JF. Beyond the SCENIC route: updates in chromoendoscopy and dysplasia screening in patients with inflammatory bowel disease. Gastrointest Endosc 2022; 95: 30-37
    CrossrefPubMedSuche in Google Scholar
  • 35 Murthy SK, Feuerstein JD, Nguyen GC. et al. AGA Clinical Practice Update on Endoscopic Surveillance and Management of Colorectal Dysplasia in Inflammatory Bowel Diseases: Expert Review. Gastroenterology 2021; 161: 1043-1051.e4
    CrossrefPubMedSuche in Google Scholar
  • 36 Bisschops R, East JE, Hassan C. et al. Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline-Update 2019. Endoscopy 2019; 51: 1155-1179
    Thieme ConnectPubMedSuche in Google Scholar
  • 37 Guerrero Vinsard D, Fetzer JR, Agrawal U. et al. Development of an artificial intelligence tool for detecting colorectal lesions in inflammatory bowel disease. iGIE 2023; 2: 91-101.e6
    CrossrefPubMedSuche in Google Scholar
  • 38 Ahmad HA, East JE, Panaccione R. et al. Artificial intelligence in inflammatory bowel disease: implications for clinical practice and future directions. Intest Res 2023; 21: 283-294
    CrossrefPubMedSuche in Google Scholar