Indigo Carmine-Assisted High-Magnification Chromoscopic Colonoscopy for the Detection and Characterisation of Intraepithelial Neoplasia in Ulcerative Colitis: A Prospective Evaluation

• DOI: 10.1055/s-2005-921032
• Publication Date: 2005-12-05T09:09:56Z
• Authors: D. Hurlstone; D. Sanders; A. Lobo; M. McAlindon; S. Cross
• Keywords: Intraepithelial lymphocyte

Background and Study Aims: Recent data suggest that panchromoscopy using methylene blue can improve the detection of intraepithelial neoplastic lesions in context surveillance colonoscopy for patients with chronic ulcerative colitis. This method has also been shown to provide a more accurate diagnosis extent disease inflammatory activity. Interval cancers are known occur colitis despite adoption currently accepted biopsy protocols. We hypothesised targeted chromoscopy alone, high-magnification imaging, may increase total number detected, compared conventional according current Patients Methods: A 350 long-standing (≥ 8 years) underwent chromoscopic (HMCC). Quadrantic biopsies at 10-cm intervals were taken on extubation addition abnormal mucosal areas. Defined further evaluated modified Kudo crypt pattern analysis. These from duration- extent-matched control who had undergone colonoscopic between January 2001 April 2005. Results: Significantly detected magnification group controls (69 vs. 24, P < 0.0001). Intraepithelial neoplasia was observed 67 lesions, which 53 (79 %) alone. Chromoscopy increased flat (P 0.001). Twenty 12 850 non-targeted HMCC (0.16 %), while 49 644 (8 %). From 482 patients, 18 (0.14 showed neoplasia. The yield (i. e. without imaging), however, only modestly improved 1.6 % (6/369). Using criteria, sensitivity specificity differentiating non-neoplastic 93 88 respectively. procedure time significantly longer 0.02). Conclusions: Magnification improves endoscopic screening Neoplastic change be predicted high overall accuracy techniques. adjunctive techniques have important clinical implications lead changes practice guidelines.