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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)
› Author AffiliationsSupported by: NIHR Oxford Biomedical Research Centre
Supported by: Cancer Research UK 25901
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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



Publication History

Received: 10 March 2024

Accepted after revision: 30 July 2024

Article published online:
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

Letter to this article:

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
 

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