Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Neumann, H; Vieth, M; Langner, C; Neurath, MF; Mudter, J.
Cancer risk in IBD: how to diagnose and how to manage DALM and ALM.
World J Gastroenterol. 2011; 17(27):3184-3191
Doi: 10.3748/wjg.v17.i27.3184
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- Abstract:
- The risk of developing neoplasia leading to colorectal cancer is significantly increased in ulcerative colitis (UC) and most likely in Crohn's disease. Several endoscopic surveillance strategies have been implemented to identify these lesions. The main issue is that colitis-associated neoplasms often occurs in flat mucosa, often being detected on taking random biopsies rather than by identification of these lesions via endoscopic imaging. The standard diagnostic procedure in long lasting UC is to take four biopsies every 10 cm. Image enhancement methods, such as chromoendoscopy and virtual histology using endomicroscopy, have greatly improved neoplasia detection rates and may contribute to reduced random biopsies by taking targeted "smart" biopsies. Chromoendoscopy may effectively be performed by experienced endoscopists for routine screening of UC patients. By contrast, endomicroscopy is often only available in selected specialized endoscopic centers. Importantly, advanced endoscopic imaging has the potential to increase the detection rate of neoplasia whereas the interplay between endoscopic experience and interpretation of histological biopsy evaluation allows the physician to make a proper diagnosis and to find the appropriate therapeutic approach. Colitis-associated intraepithelial neoplasms may occur in flat mucosa of endoscopically normal appearance or may arise as dysplasia-associated lesion or mass (DALM), which may be indistinguishable from sporadic adenomas in healthy or non-colitis mucosa [adenoma-like mass (ALM)]. The aim of this review was to summarize endoscopic and histological characteristics of DALM and ALM in the context of therapeutic procedures.
- Find related publications in this database (using NLM MeSH Indexing)
- Adenoma - pathology
- Biopsy -
- Colitis, Ulcerative - complications
- Colonoscopy - methods
- Crohn Disease - complications
- Endoscopy - methods
- Gastroenterology - methods
- Humans -
- Inflammatory Bowel Diseases - complications
- Medical Oncology - methods
- Microscopy - methods
- Microscopy, Confocal - methods
- Mutation -
- Neoplasms - complications
- Find related publications in this database (Keywords)
- Inflammatory bowel disease
- Crohn's disease
- Endoscopy
- Colitis
- Dysplasia-associated lesion or mass
- Adenoma-like mass
- Endomicroscopy
- Ulcerative colitis
- Endomicroscopy
- Confocal laser endomicroscopy
- Probe-based confocal laser endomicroscopy
- Integrated confocal laser endomicroscopy
- Endoscope-based confocal laser endomicroscopy
- Narrow band imaging
- Chromoendoscopy
- Cancer
- Dysplasia