Magnifying chromoendoscopy with narrow band imaging for dysplasia and colorectal cancer in inflammatory bowel disease / 中华消化内镜杂志

ABSTRACT

Objective To study the diagnostic value of magnifying chromoendoscopy combined with narrow band imaging (NBI) for screening inflammatory bowel disease (IBD) and colorectal cancer(CRC).Methods In colonoscopic examinations of long-term IBD patients,magnifying colonoscopy was used to make the consecutive observation with white light,NBI,and indigo carmine spraying.Targeted biopsies or endoscopic resections were performed for histological diagnosis as the golden standard of this study.Results Sixteen cases (17 lesions) with dysplasia or colorectal cancer in 45 long-term IBD patients were detected,including 12 (26.7％) cases of low-grade dysplasia (LGD),4 (8.9％) cases of high-grade dysplasia (HGD),and 1 (2.2％) case of CRC.Targeted biopsy yielded a positive rate of 13.2％ (17/129).Detection rates of NICE and Kudo classification were 81.3％ (13/16) and 75.0％ (12/16),respectively,and were 100.0％ when combined together.Age (P =0.027) and prolonged disease course (P =0.013)were associated with advanced histology in those with dysplasia or CRC.Lesions of HGD and CRC have larger diameters (2.5 ± 1.4 cm) than LGD (0.6 ± 0.4 cm) (P =0.003).Conclusion Magnifying chromoendoscopy with NBI is effective to detect and differentiate colitis-related neoplastic lesions,thus allowing rational therapeutic plans.