title: Is it possible to discriminate between neoplastic and nonneoplastic lesions in ulcerative colitis by magnifying colonoscopy?
abstract: BACKGROUND
  Colitis-associated cancer/dysplasia is an intestinal tract condition that can affect the life expectancy of patients with ulcerative colitis. It is often difficult to detect neoplastic lesions. This study evaluated whether any endoscopic features are effective for distinguishing colitis-associated cancer/dysplasia from nonneoplastic lesions in patients with ulcerative colitis.
  
  
  METHODS
  The study involved 52 patients with 61 lesions treated at Hiroshima University Hospital between September 1999 and May 2012: 10 patients with 11 dysplastic lesions, 5 patients with 5 intramucosal carcinomas, 3 patients with 3 submucosal carcinomas, and 34 patients with 42 nonneoplastic lesions. All patients had undergone targeted biopsy. Endoscopic findings were compared between patients with biopsy-determined neoplasia and those with biopsy-determined nonneoplasia. Multivariate regression analysis was performed to identify magnifying chromocolonoscopy features predictive of neoplasia.
  
  
  RESULTS
  No significant difference was found in conventional endoscopy features between the neoplastic and nonneoplastic lesions. Under magnifying chromocolonoscopy, the pit density of the neoplastic lesions was found to be significantly greater than that of the nonneoplastic lesions (89% [17/19] versus 60% [25/42], respectively). Pit margins were more frequently irregular in the neoplastic lesions than in the nonneoplastic lesions (63% [12/19] versus 33% [14/42], respectively).
  
  
  CONCLUSIONS
  In differentiating between colitis-associated neoplastic and nonneoplastic lesions, focus should be on the high residual density of pits and irregular pit margins observed under magnifying chromocolonoscopy.
authors.affiliation: *Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan; †Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan; ‡Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, Japan; and §Department of Pathology, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Soki
authors.initials: S
authors.lastname: Nishiyama
authors.forename: Shiro
authors.initials: S
authors.lastname: Oka
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Nana
authors.initials: N
authors.lastname: Hayashi
authors.forename: Ryohei
authors.initials: R
authors.lastname: Hayashi
authors.forename: Kenta
authors.initials: K
authors.lastname: Nagai
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Ueno
authors.forename: Fumio
authors.initials: F
authors.lastname: Shimamoto
authors.forename: Koji
authors.initials: K
authors.lastname: Arihiro
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology; D003111:Colonic Polyps / Q000175:diagnosis* / Q000209:etiology; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis