Comparison of Targeted vs Random Biopsies for Surveillance of Ulcerative Colitis-Associated Colorectal Cancer
| Autor: | Toru Takebayashi, Shinji Tanaka, Reiko Kunisaki, Yasuo Suzuki, Nobuyuki Hida, Keisuke Hata, Masakazu Nagahori, Hiroyuki Hanai, Mamoru Watanabe, Kazunari Murakami, Fumiaki Ueno, Masahiro Igarashi, Naoki Tomotsugu, Kenji Watanabe, Toshiaki Watanabe, Keiichi Mitsuyama, Kazuo Ohtsuka, Kiyonori Kobayashi, Bunei Iizuka, Keiji Matsuda, Ichiro Hirata, Ryuichi Iwakiri, Shin-ei Kudo, Gen Watanabe, Eisuke Inoue, Kenichi Sugihara, Yasushi Iwao, Yoshiaki Takeuchi, Takayuki Matsumoto, Koji Oba, Yoko Ito, Yoichi Ajioka, Toshifumi Hibi, Hiroshi Nakase, Masahiro Ikegami |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Dysplasia medicine.medical_specialty Colorectal cancer Biopsy Operative Time IBD Random Biopsy Colonoscopy Gastroenterology law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Clinical endpoint Humans Hepatology medicine.diagnostic_test business.industry Middle Aged medicine.disease Ulcerative colitis Confidence interval Clinical trial Population Surveillance 030220 oncology & carcinogenesis Colitis Ulcerative Female 030211 gastroenterology & hepatology Colorectal Neoplasms business |
| Zdroj: | Gastroenterology. 151:1122-1130 |
| ISSN: | 0016-5085 |
| DOI: | 10.1053/j.gastro.2016.08.002 |
| Popis: | Background & AimsA random biopsy is recommended for surveillance of ulcerative colitis (UC)-associated colorectal cancer. However, a targeted biopsy might be more effective. We conducted a randomized controlled trial to compare rates of neoplasia detection by targeted vs random biopsies in patients with UC.MethodsWe performed a study of 246 patients with UC for 7 years or more, seen at 52 institutions in Japan from October 1, 2008 through December 31, 2010. Patients were randomly assigned to the random group (4 random biopsies collected every 10 cm in addition to targeted biopsies, n = 122) or the target group (biopsies collected from locations of suspected neoplasia, n = 124). The primary end point was the number of neoplastic lesions detected in a single surveillance colonoscopy. We estimated the ratio and difference in the mean number of neoplastic lesions between the groups. We also evaluated the non-inferiority between the groups as an exploratory study. A non-inferiority margin of 0.65 (0.13 of 0.20) was considered for the ratio of the mean number of neoplastic lesions between groups.ResultsThe mean number of biopsies found to contain neoplastic tissue per colonoscopy was 0.211 (24 of 114) in the target group and 0.168 (18 of 107) in the random group (ratio of 1.251; 95% confidence interval, 0.679–2.306). The lower limit was above the non-inferiority margin of 0.65. Neoplasias were detected in 11.4% of patients in the target group and 9.3% of patients in the random group (P = .617). Larger numbers of biopsy samples per colonoscopy were collected in the random group (34.8 vs 3.1 in the target group; P < .001), and the total examination time was longer (41.7 vs 26.6 minutes in the target group; P |
| Databáze: | OpenAIRE |
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