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

Rodrigo V Motta; Vipin Gupta; Karen Hartery; Paul Bassett; Simon J Leedham; Roger W Chapman; Simon PL Travis; Emma L Culver; James E. East

doi:10.1055/a-2437-8102

Endoscopy International Open, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(11): E1285-E1294
DOI: 10.1055/a-2437-8102

Original article

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

Rodrigo V Motta‡

¹Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6396)

,

Vipin Gupta‡

²Department of Gastroenterology, North Bristol NHS Trust, Bristol, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN1982)

,

Karen Hartery

³Department of Gastroenterology, St James's Hospital, Dublin, Ireland (Ringgold ID: RIN58024)

,

Paul Bassett

⁴Statistics, Statsconsultancy Ltd, Buckinghamshire, United Kingdom of Great Britain and Northern Ireland

,

Simon J Leedham

⁵Gastrointestinal Stem Cell Biology Lab, Wellcome Centre Human Genetics, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6396)

,

Roger W Chapman

¹Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6396)

,

Simon PL Travis

⁶Translational 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 (Ringgold ID: RIN6396)

,

Emma L Culver^*

¹Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6396)

,

James E. East^*

¹Translational Gastroenterology and Liver Unit, Experimental Medicine Division, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6396)

› Institutsangaben

Abstract

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.

Keywords

Endoscopy Lower GI Tract - Inflammatory bowel disease - CRC screening - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE...)

Bibliographical Record
Rodrigo V Motta, Vipin Gupta, Karen Hartery, Paul Bassett, Simon J Leedham, Roger W Chapman, Simon PL Travis, Emma L Culver, James E. East. Dye-based chromoendoscopy detects more neoplasia than white light endoscopy in patients with primary sclerosing cholangitis and IBD. Endosc Int Open 2025; 13.
DOI: 10.1055/a-2437-8102

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Referenzen

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