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

Autor:	Motta RV; Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland., Gupta V; Department of Gastroenterology, North Bristol NHS Trust, Bristol, United Kingdom of Great Britain and Northern Ireland., Hartery K; Department of Gastroenterology, St James's Hospital, Dublin, Ireland., Bassett P; Statistics, Statsconsultancy Ltd, Buckinghamshire, United Kingdom of Great Britain and Northern Ireland., Leedham SJ; Gastrointestinal Stem Cell Biology Lab, Wellcome Centre Human Genetics, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland., Chapman RW; Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland., Travis SP; 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., Culver EL; Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland., East JE; Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland.
Jazyk:	angličtina
Zdroj:	Endoscopy international open [Endosc Int Open] 2024 Nov 11; Vol. 12 (11), pp. E1285-E1294. Date of Electronic Publication: 2024 Nov 11 (Print Publication: 2024).
DOI:	10.1055/a-2437-8102
Abstrakt:	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. Competing Interests: Conflict of Interest Simon PL Travis has served as a paid consultant to AbbVie, Allergan, Amgen, Asahi, Bioclinica, Biogen, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, ChemoCentryx, Cosmo, Enterome, Equillium, Ferring, GSK, Genentech, Genzyme, Giuliani SpA, Immunocore, Immunometabolism, Janssen, Lilly, MSD, Merck, Mestag, Neovacs, Novo Nordisk, NPS Pharmaceuticals, Pfizer, Proximagen, Receptos, Roche, Satisfai Health, Sensyne Health, Shire, Sigmoid Pharma, Sorriso, Takeda, Topivert, UCB, VHsquared, Vifor, and Zeria. He has received grants and/or has grants pending from AbbVie, ECCO, Helmsley Trust, IOIBD, Janssen, Lilly, Norman Collisson Foundation, Pfizer, UCB, UKIERI, and Vifor. He has received honoraria from AbbVie, Amgen, Biogen, Ferring, Lilly, Pfizer, and Takeda. He has had travel/accommodation expenses covered or reimbursed by AbbVie, Amgen, Biogen, Ferring, Lilly, JNJ, Pfizer, and Takeda. Emma Culver: Speaking Fees: Horizon Therapeutics, Advanz (Intercept), Albireo, Dr Falk Pharma, Gilead, GSK; Consulting Fees: Advanz (Intercept), Horizon Therapeutics, Ipsen, Mirum, Moderna, Sanofi, Zenus Pharma; Grant Support: Jansen, Innovate UK, PSC Support, Wellcome Trust; Institutional Funding Support: BRC Oxford NIHR (UK), Oxford Charitable Fund, Research Capability Fund. James E East has served on clinical advisory boards for Lumendi, Boston Scientific, and Paion; has served on the clinical advisory board and has share options in Satisfai Health; and reports speaker fees from Falk, Janssen and Medtronic. The remaining authors declare no conflict of interests. (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/).)
Databáze:	MEDLINE
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