Publication

Low frequency of colorectal dysplasia in patients with long-standing inflammatory bowel disease colitis: detection by fluorescence endoscopy

Journal Paper/Review - May 1, 2006

Units
PubMed
Doi

Citation
Ochsenkühn T, Tillack C, Stepp H, Diebold J, Ott S, Baumgartner R, Brand S, Göke B, Sackmann M. Low frequency of colorectal dysplasia in patients with long-standing inflammatory bowel disease colitis: detection by fluorescence endoscopy. Endoscopy 2006; 38:477-82.
Type
Journal Paper/Review (English)
Journal
Endoscopy 2006; 38
Publication Date
May 1, 2006
Issn Print
0013-726X
Pages
477-82
Brief description/objective

BACKGROUND AND STUDY AIM
Patients with long-standing inflammatory bowel disease (IBD) have an increased risk of developing colonic dysplasias. Dysplastic changes in flat mucosa are likely to be missed by conventional colonoscopy. Endoscopic fluorescence imaging, using 5-aminolevulinic acid (5-ALA) as photosensitizer, has evolved as a new technique to differentiate between normal colonic mucosa and dysplasia. We combined this technique with random biopsies to prospectively evaluate the occurrence of dysplasias in patients with long-standing IBD.

PATIENTS AND METHODS
52 colonoscopies were performed in 42 consecutive patients (n = 28 with ulcerative colitis, n = 11 with Crohn's colitis, n = 3 with indeterminate colitis; mean age 43 years, range 21 - 78) with long-standing IBD colitis (median disease duration 14 years, range 3 - 40). All patients were in clinical remission. Patients were examined using both conventional white light and by fluorescence colonoscopy using oral 5-ALA. Four biopsies were taken every 10 cm from mucosa of normal appearance. In addition, macroscopically suspicious and fluorescence-positive areas were biopsied.

RESULTS
A total of 688 biopsies of red-fluorescent (n = 20) and nonfluorescent (n = 662) areas of mucosa were taken. Dysplasia was detected histopathologically in only two of the biopsies. These biopsies were taken from two polypoid lesions which were fluorescence-negative.

CONCLUSIONS
The rate of colonic dysplasia in patients with long-standing IBD colitis may be lower than previously reported.