DNA content analysis of colorectal serrated lesions detects an aneuploid subset of inflammatory bowel disease-associated serrated epithelial change and traditional serrated adenomas

2018 ◽  
Vol 73 (3) ◽  
pp. 464-472 ◽  
Author(s):  
Won-Tak Choi ◽  
Kwun Wah Wen ◽  
Peter S Rabinovitch ◽  
Danning Huang ◽  
Aras N Mattis ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Content Analysis ◽  
Dna Content ◽  
Bowel Disease ◽  
Serrated Lesions ◽  
Inflammatory Bowel ◽  
Epithelial Change ◽  
Serrated Adenomas

scholarly journals Prevalence and Anatomic Distribution of Serrated and Adenomatous Lesions in Patients with Inflammatory Bowel Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Lik Hang Lee ◽  
Marietta Iacucci ◽  
Miriam Fort Gasia ◽  
Subrata Ghosh ◽  
Remo Panaccione ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Tertiary Care ◽  
Premalignant Lesions ◽  
Similar Distribution ◽  
Care Hospital ◽  
Anatomic Distribution ◽  
Serrated Lesions ◽  
Inflammatory Bowel ◽  
Serrated Adenomas

Background. Sessile serrated adenomas/polyps (SSA/Ps) and traditional serrated adenomas (TSAs) have not been well characterized in patients with inflammatory bowel disease (IBD). This study assesses the prevalence and anatomic distribution of SSA/Ps, TSAs, and conventional adenomas/dysplasia (Ad/Ds) in IBD patients.Methods. IBD patients with serrated, adenomatous, or hyperplastic lesions between 2005 and 2009 were identified in the regional tertiary-care hospital database. Clinicopathological information was reviewed and the histology of biopsies was reevaluated.Results. Ninety-six Ad/Ds, 25 SSA/Ps, and 4 TSAs were identified in 83 patients. Compared to Ad/Ds, serrated lesions were more prevalent in females (p=0.046). The prevalence of Ad/Ds was 4.95%, SSA/Ps was 1.39%, and TSAs was 0.31%. No relationship was identified between lesion type and IBD type. Comparing all IBD patients, the distribution of lesion types was significantly different (p=0.02) with Ad/Ds more common distally, SSA/Ps more common proximally, and TSAs evenly distributed. Among Crohn’s disease (CD) patients, a similar distribution difference was noted (p<0.001). However, ulcerative colitis (UC) patients had a uniform distribution of lesion types (p=0.320).Conclusions. IBD patients have a lower prevalence of premalignant lesions compared to the general population, and the anatomic distribution of lesions differed between CD and UC patients. These findings may indicate an interaction between lesion and IBD pathogenesis with potential clinical implications.

scholarly journals P307 Colorectal neoplasia risk in patients with inflammatory bowel disease and serrated lesions

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S307-S308
Author(s):  
M De Jong ◽  
S Vos ◽  
I Nagtegaal ◽  
Y van Herwaarden ◽  
L Derikx ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Colorectal Neoplasia ◽  
Classification Systems ◽  
Advanced Neoplasia ◽  
Increased Risk ◽  
Serrated Lesions ◽  
Inflammatory Bowel ◽  
Serrated Lesion ◽  
The Impact

Abstract Background The presence of serrated lesions (SLs) is an established risk factor for colorectal neoplasia development in the general population. However, the impact of SLs on the colorectal neoplasia risk in inflammatory bowel disease (IBD) patients is unknown. In addition, SLs might have been misclassified in IBD patients in the past, in part due to revisions of classification systems. Presently, SLs are categorised as hyperplastic lesions, sessile SLs, and traditional serrated adenomas. We aimed (1) to compare the colorectal neoplasia risk in IBD patients with SLs vs. IBD patients without SLs, and 2) to study the subclassification of SLs in IBD patients before and after histopathological review by two expert gastrointestinal pathologists. Methods We identified all IBD patients with colonic SLs from 1996 to 2019 in a tertiary referral centre using the local histopathology database. Patients with neoplasia prior to SL diagnosis were excluded. Clinical data from patients’ charts were retrieved until June 2019. A subgroup of 135 SLs was reviewed by two pathologists. The log-rank analysis was used to compare the cumulative (advanced) neoplasia incidence in IBD patients with SL vs. IBD patients without SL undergoing surveillance in the same time period. Patients were censored at the end of surveillance or at colectomy. Results We identified 376 SLs in 204 IBD patients (61.9% ulcerative colitis (UC)). In the original reports, 91.9% was classified as a hyperplastic lesion. After histopathological review, 120/136 (88%) of the SLs were confirmed (16 were no SL). Of the 120 confirmed SLs, 62.2% was classified as a sessile SL, 37.8% as a hyperplastic lesion, and 0.8% as a traditional serrated adenoma. The mean time from IBD diagnosis to the first serrated lesion was 14.3 ( ± 12.3) years. A total of 41/204 (20.0%) of patients developed neoplasia (3 CRC, 3 HGD, and 35 LGD; including 2 HGD and 17 LGD at the moment of serrated lesion detection). In the 304 patients without SL (52.6% UC), 63 developed neoplasia (20.7%; 8 CRC, 5 HGD and 50 LGD). Patients who received follow-up colonoscopies after SL (n = 127) had an increased cumulative risk of neoplasia (p &lt; 0.01), but no increased risk of advanced neoplasia (p = 0.50) compared with the group of IBD patients without SL (Figure 1). Conclusion The presence of SLs in IBD patients was associated with a relatively high risk of synchronous colorectal neoplasia as well as an increased risk of subsequent neoplasia, although not with an increased risk of advanced neoplasia. Histopathological review confirmed the SL diagnosis in the majority of lesions, although a large proportion of the hyperplastic lesions was reclassified as a sessile SL.

Significance of serrated epithelial change in inflammatory bowel disease

2020 ◽  
pp. 1-5
Author(s):  
Kenneth P. Batts ◽  
Mohamed Atwaibi ◽  
David I. Weinberg ◽  
Robert P. McCabe
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Inflammatory Bowel ◽  
Epithelial Change

scholarly journals Advanced neoplasia detection using chromoendoscopy and white light colonoscopy for surveillance in patients with inflammatory bowel disease

2020 ◽  
Vol 18 (4) ◽  
pp. 438-446
Author(s):  
Kyeong Ok Kim ◽  
Michael V. Chiorean
Keyword(s):  
Inflammatory Bowel Disease ◽  
White Light ◽  
Bowel Disease ◽  
Paired Comparison ◽  
Interval Cancer ◽  
White Light Endoscopy ◽  
Advanced Neoplasia ◽  
Serrated Lesions ◽  
Inflammatory Bowel ◽  
The Impact

Background/Aims: Chromoendoscopy (CE) has been shown to be superior to white light endoscopy (WLE) for neoplasia detection in inflammatory bowel disease (IBD). We aimed to compare the yield of CE and WLE for the detection of overall neoplasia and advanced neoplasia in IBD. Methods: Patients who underwent surveillance colonoscopy from 1999 to 2017 were identified from our IBD database. CE procedures were compared with their respective WLE controls in a paired comparison, and frequency of all neoplasia, advanced neoplasia, and serrated neoplasia was assessed for both targeted and random biopsies.Results: A total of 290 procedures performed in 98 individuals were identified with a median follow-up 4 years (median 3 colonoscopies/patient). CE and WLE were performed in 159 and 131 episodes, respectively. CE detected neoplasia in 40.9% of colonoscopies versus 23.7% with WLE (<i>P</i>= 0.002). In addition, CE detected more advanced neoplasia (18.2% vs. 6.1%, <i>P</i>= 0.002) and serrated lesions (14.5% vs. 6.1%, <i>P</i>= 0.022). Significantly fewer samples were obtained per procedure with CE (14.9 ± 9.7 vs. 20.9 ± 11.1, <i>P</i>< 0.001). Cancer was diagnosed in 2 cases.Conclusions: CE has a higher detection rate than WLE for advanced neoplasia and serrated lesions in patients with IBD under surveillance. Further prospective studies evaluating the impact of CE on decreasing the risk of interval cancer and colectomy in IBD patients are warranted.

Specific quality of life factors in patients with inflammatory bowel disease

2012 ◽  
Vol 153 (38) ◽  
pp. 1511-1519 ◽  
Author(s):  
Beáta Nagy ◽  
Réka Laczkóné Majer
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Content Analysis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Bowel Disease ◽  
Control Group ◽  
Inflammatory Bowel

Introduction: Inflammatory bowel disease is a chronic disease with a fluctuating course and unknown origin. Its two major forms are Crohn’s disease and ulcerative colitis. Objective: The authors attempted to analyse the quality of life of patients with inflammatory bowel disease as compared to healthy persons and patients with asthma in order to identify specific factors which most significantly affect the quality of life of these patients. Method: 269 subjects participated in the study (control group, 115 subjects; Crohn’s disease, 67 patients; ulcerative colitis, 25 patients; asthma, 62 patients). The following methods were used: WHO-5, IIRS, SIBDQ and AQLQ(S) questionnaires and content analysis. Results: Patients with inflammatory bowel disease had the worst quality of life with respect to both subjective well-being and burden of disease. The results obtained from questionnaires developed for the analysis of quality of life indicated that extraintestinal symptoms and emotional problems are the major factors which interfere with the quality of life of patients with inflammatory bowel disease. These findings were confirmed by content analysis of interviews with patients. Conclusions: The authors recommend that more attention should be paid to improving the quality of life of patients with inflammatory bowel disease and helping them to live with the illness, especially at the level of interpersonal relations. Orv. Hetil., 2012, 153, 1511–1519.

scholarly journals Serrated lesions in inflammatory bowel disease

2017 ◽  
Vol 85 (2) ◽  
pp. 461 ◽  
Author(s):  
Alexandros D. Polydorides ◽  
Noam Harpaz
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Serrated Lesions ◽  
Inflammatory Bowel

Serrated Lesions in Inflammatory Bowel Disease: Genotype-Phenotype Correlation

2020 ◽  
pp. 106689692096379
Author(s):  
Iva Brcic ◽  
Heather Dawson ◽  
Hans Peter Gröchenig ◽  
Christoph Högenauer ◽  
Karl Kashofer
Keyword(s):  
Inflammatory Bowel Disease ◽  
Molecular Analysis ◽  
Bowel Disease ◽  
Low Grade ◽  
Right Colon ◽  
Kras Mutations ◽  
Increased Risk ◽  
Serrated Lesions ◽  
Inflammatory Bowel ◽  
The Right

Background Patients with inflammatory bowel disease (IBD) and hyperplastic/serrated polyposis have an increased risk of colorectal cancer. The aim of our study was to elucidate the nature of serrated lesions in IBD patients. Materials and Methods Sixty-five lesions with serrated morphology were analyzed in 39 adult IBD patients. Lesions were classified according to the WHO 2019 criteria or regarded as reactive, and molecular analysis was performed. Results 82.1% of patients had ulcerative colitis, 17.9% had Crohn’s disease; 51.3% were female, and the mean age was 54.5 years. The duration of IBD varied significantly (16.7 ± 11.4 years). Endoscopy showed polypoid lesions in 80.3%; the size ranged from 2 to 20 mm. A total of 21.6% of the lesions were located in the right colon. Five lesions were classified as inflammatory pseudopolyps, 28 as hyperplastic polyp, 21 and 2 as sessile serrated lesion without and with dysplasia, respectively, and 9 as traditional serrated adenoma with low-grade dysplasia. Analysis of all true serrated lesions revealed 31 mutations in KRAS and 32 in BRAF gene. No mutations were identified in inflammatory pseudopolyps. In the right colon BRAF mutations were more frequent than KRAS (16 vs 3), while KRAS mutations prevailed on the left side (28 vs 16, P < .001). One patient with traditional serrated adenomas progressed to an adenocarcinoma after 61 months. Conclusion The molecular analysis could help discriminate true serrated lesions (IBD-associated or not) from reactive pseudopolyps with serrated/hyperplastic epithelial change. These should help in more accurate classification of serrated lesions.

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