Endoscopic Predictors of Neoplastic Lesions in Inflammatory Bowel Diseases Patients Undergoing Chromoendoscopy
Dye-based chromoendoscopy (DCE) with targeted biopsies is recommended for surveillance of patients with long-standing inflammatory bowel diseases (IBD), but endoscopic features that predict dysplasia are not fully clarified. We here aimed at identifying predictive factors of dysplastic/neoplastic le...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/18/4426 |
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| author | Elisabetta Lolli Elena De Cristofaro Irene Marafini Edoardo Troncone Benedetto Neri Francesca Zorzi Livia Biancone Emma Calabrese Giovanni Monteleone |
| author_facet | Elisabetta Lolli Elena De Cristofaro Irene Marafini Edoardo Troncone Benedetto Neri Francesca Zorzi Livia Biancone Emma Calabrese Giovanni Monteleone |
| author_sort | Elisabetta Lolli |
| collection | DOAJ |
| description | Dye-based chromoendoscopy (DCE) with targeted biopsies is recommended for surveillance of patients with long-standing inflammatory bowel diseases (IBD), but endoscopic features that predict dysplasia are not fully clarified. We here aimed at identifying predictive factors of dysplastic/neoplastic lesions in IBD patients undergoing DCE. Two-hundred-and-nineteen patients were consecutively and prospectively enrolled from October 2019 to March 2022. One-hundred-and-forty-five out of 219 patients underwent DCE, and 148 lesions were detected in 79/145 (54%) patients. Thirty-nine lesions (26%) were dysplastic and one of them contained a CRC. Among these lesions, 7 (17.9%) had Kudo pit pattern I-II and 32 (82.1%) had a neoplastic pit pattern (Kudo III-IV). Multivariate analysis showed that neoplastic lesions Kudo III-IV (OR: 5.8, 95% CI: 2.3–14.6; <i>p</i> = 0.0002), lesion’s size (OR 1.16, 95% CI: 1.06–1.26; <i>p</i> = 0.0009), and polypoid lesions according to Paris Classification (OR 7.4, 95% CI: 2.7–20.2; <i>p</i> = 0.0001) were independent predictors of dysplasia. A cut-off of lesion’s size > 7 mm was identified as the best predictor of dysplasia. Among such features, Kudo pit pattern III-IV had the highest sensitivity and specificity to predict dysplasia (79% and 80%, respectively). Lesions with all three endoscopic features had a sensitivity of 90% and specificity of 100% to predict dysplasia. In contrast, non-polypoid lesions were inversely associated with dysplasia (OR 0.13, 95% CI: 0.05–0.36; <i>p</i> = 0.0001). These findings indicate that, in IBD patients, DCE-evidenced polypoid lesions with Kudo pit pattern III-IV and size > 7 mm are frequently dysplastic. |
| first_indexed | 2024-03-10T00:31:02Z |
| format | Article |
| id | doaj.art-e259f4dfa81f45a5a36a4537e023d787 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T00:31:02Z |
| publishDate | 2022-09-01 |
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| series | Cancers |
| spelling | doaj.art-e259f4dfa81f45a5a36a4537e023d7872023-11-23T15:27:03ZengMDPI AGCancers2072-66942022-09-011418442610.3390/cancers14184426Endoscopic Predictors of Neoplastic Lesions in Inflammatory Bowel Diseases Patients Undergoing ChromoendoscopyElisabetta Lolli0Elena De Cristofaro1Irene Marafini2Edoardo Troncone3Benedetto Neri4Francesca Zorzi5Livia Biancone6Emma Calabrese7Giovanni Monteleone8Azienda Ospedaliera Policlinico Tor Vergata, 00133 Rome, ItalyAzienda Ospedaliera Policlinico Tor Vergata, 00133 Rome, ItalyAzienda Ospedaliera Policlinico Tor Vergata, 00133 Rome, ItalyAzienda Ospedaliera Policlinico Tor Vergata, 00133 Rome, ItalyAzienda Ospedaliera Policlinico Tor Vergata, 00133 Rome, ItalyAzienda Ospedaliera Policlinico Tor Vergata, 00133 Rome, ItalyAzienda Ospedaliera Policlinico Tor Vergata, 00133 Rome, ItalyAzienda Ospedaliera Policlinico Tor Vergata, 00133 Rome, ItalyAzienda Ospedaliera Policlinico Tor Vergata, 00133 Rome, ItalyDye-based chromoendoscopy (DCE) with targeted biopsies is recommended for surveillance of patients with long-standing inflammatory bowel diseases (IBD), but endoscopic features that predict dysplasia are not fully clarified. We here aimed at identifying predictive factors of dysplastic/neoplastic lesions in IBD patients undergoing DCE. Two-hundred-and-nineteen patients were consecutively and prospectively enrolled from October 2019 to March 2022. One-hundred-and-forty-five out of 219 patients underwent DCE, and 148 lesions were detected in 79/145 (54%) patients. Thirty-nine lesions (26%) were dysplastic and one of them contained a CRC. Among these lesions, 7 (17.9%) had Kudo pit pattern I-II and 32 (82.1%) had a neoplastic pit pattern (Kudo III-IV). Multivariate analysis showed that neoplastic lesions Kudo III-IV (OR: 5.8, 95% CI: 2.3–14.6; <i>p</i> = 0.0002), lesion’s size (OR 1.16, 95% CI: 1.06–1.26; <i>p</i> = 0.0009), and polypoid lesions according to Paris Classification (OR 7.4, 95% CI: 2.7–20.2; <i>p</i> = 0.0001) were independent predictors of dysplasia. A cut-off of lesion’s size > 7 mm was identified as the best predictor of dysplasia. Among such features, Kudo pit pattern III-IV had the highest sensitivity and specificity to predict dysplasia (79% and 80%, respectively). Lesions with all three endoscopic features had a sensitivity of 90% and specificity of 100% to predict dysplasia. In contrast, non-polypoid lesions were inversely associated with dysplasia (OR 0.13, 95% CI: 0.05–0.36; <i>p</i> = 0.0001). These findings indicate that, in IBD patients, DCE-evidenced polypoid lesions with Kudo pit pattern III-IV and size > 7 mm are frequently dysplastic.https://www.mdpi.com/2072-6694/14/18/4426Crohn’s diseaseulcerative colitisdysplasiaKudo pit patterncolitis-associated colorectal cancer |
| spellingShingle | Elisabetta Lolli Elena De Cristofaro Irene Marafini Edoardo Troncone Benedetto Neri Francesca Zorzi Livia Biancone Emma Calabrese Giovanni Monteleone Endoscopic Predictors of Neoplastic Lesions in Inflammatory Bowel Diseases Patients Undergoing Chromoendoscopy Cancers Crohn’s disease ulcerative colitis dysplasia Kudo pit pattern colitis-associated colorectal cancer |
| title | Endoscopic Predictors of Neoplastic Lesions in Inflammatory Bowel Diseases Patients Undergoing Chromoendoscopy |
| title_full | Endoscopic Predictors of Neoplastic Lesions in Inflammatory Bowel Diseases Patients Undergoing Chromoendoscopy |
| title_fullStr | Endoscopic Predictors of Neoplastic Lesions in Inflammatory Bowel Diseases Patients Undergoing Chromoendoscopy |
| title_full_unstemmed | Endoscopic Predictors of Neoplastic Lesions in Inflammatory Bowel Diseases Patients Undergoing Chromoendoscopy |
| title_short | Endoscopic Predictors of Neoplastic Lesions in Inflammatory Bowel Diseases Patients Undergoing Chromoendoscopy |
| title_sort | endoscopic predictors of neoplastic lesions in inflammatory bowel diseases patients undergoing chromoendoscopy |
| topic | Crohn’s disease ulcerative colitis dysplasia Kudo pit pattern colitis-associated colorectal cancer |
| url | https://www.mdpi.com/2072-6694/14/18/4426 |
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