Intestinal Research

Original Articles

IBD/ Endoscopy

Adequacy of sigmoidoscopy as compared to colonoscopy for assessment of disease activity in patients of ulcerative colitis: a prospective study: Sameet Tariq Patel, Anuraag Jena, Sanjay Chandnani, Shubham Jain, Pankaj Nawghare, Saurabh Bansal, Harsh Gandhi, Rishikesh Malokar, Jay Chudasama, Prasanta Debnath, Seemily Kahmei, Rima Kamat, Sangeeta Kini, Qais Q Contractor, Pravin M Rathi; Intest Res 2024;22(3):310-318. Published online May 16, 2024; DOI: https://doi.org/10.5217/ir.2023.00174

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Patients of ulcerative colitis (UC) on follow-up are routinely evaluated by sigmoidoscopy. There is no prospective literature to support this practice. We assessed agreement between sigmoidoscopy and colonoscopy prospectively in patients with disease extent beyond the sigmoid colon.
Methods
We conducted a prospective observational study at a tertiary care institute for agreement between sigmoidoscopy and colonoscopy. We assessed endoscopic activity using the Mayo Endoscopic Score (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and histological activity using the Nancy Index (NI), Robarts Histopathology Index (RHI), and Simplified Geboes Score (SGS).
Results
Sigmoidoscopy showed a strong agreement with colonoscopy for MES and UCEIS with a kappa (κ) of 0.96 and 0.94 respectively. The misclassification rate for MES and UCEIS was 3% and 5% respectively. Sigmoidoscopy showed perfect agreement (κ = 1.00) with colonoscopy for assessment of the presence of endoscopic activity in the colon using MES ≥ 1 as activity criteria and strong agreement (κ = 0.93) using MES > 1 as activity criteria. Sigmoidoscopy showed strong agreement with colonoscopy for assessment of the presence of endoscopic activity using UCEIS (κ = 0.92). Strong agreement was observed between sigmoidoscopy and colonoscopy using NI (κ = 0.86), RHI (κ = 1.00), and SGS (κ = 0.92) for the detection of histological activity. The misclassification rate for the detection of histological activity was 2%, 0%, and 1% for NI, RHI, and SGS respectively.
Conclusions
Sigmoidoscopy showed strong agreement with colonoscopy for endoscopic and histologic disease activity. Sigmoidoscopy is adequate for assessment of disease activity in patients with UC during follow-up evaluation.

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Endoscopy

Histologic discrepancy between endoscopic forceps biopsy and endoscopic mucosal resection specimens of colorectal polyp in actual clinical practice: Moon Joo Hwang, Kyeong Ok Kim, A Lim Kim, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim; Intest Res 2018;16(3):475-483. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.475

Abstract PDF PubReader ePub

Background/Aims

We aimed to assess the rate of histologic discrepancy (HD) between endoscopic forceps biopsy (EFB) and totally resected specimens in colorectal polyp and analyze the risk factors of discordant group, especially under-diagnosis (UD) cases before complete removal of colorectal polyp.

Methods

From 2010 to 2015, a total of 290 polyps in 210 patients which had baseline pathology report before endoscopic resection (ER) were analyzed. UD cases were defined as those in which the diagnosis changed to a more advanced histologic feature after ER.

Results

A change in the final histology after ER was noted in 137 cases (47.2%), and after excluding 9 insignificant cases, 128 cases were further categorized into over-diagnosed and under-diagnosed group. UD occurred in 86 cases (29.7%) and change from benign to malignancy was noted in 26 cases (8.9%). On univariate analysis, a larger polyp size (>10 mm) was significantly associated with both HD (P<0.001) and UD (P<0.001). Regarding polyp morphology, protruding or flat was not significantly important. On multivariate analysis, polyp size >10 mm was the single most significant predictor of both HD (P<0.001) and UD (P<0.001).

Conclusions

The HD and UD rates were 47.2% and 29.7%, respectively. Polyp size >10 mm was the most important predictor of both HD and UD. We should be careful in making treatment strategy of colorectal polyp based on histologic report of EFB especially when the size of polyp is >10 mm.

Citations

Citations to this article as recorded by

Genetic Analysis of Biopsy Tissues from Colorectal Tumors in Patients with Ulcerative Colitis
Noriko Yamamoto, Yuji Urabe, Hikaru Nakahara, Takeo Nakamura, Daisuke Shimizu, Hirona Konishi, Kazuki Ishibashi, Misa Ariyoshi, Ryo Miyamoto, Junichi Mizuno, Takeshi Takasago, Akira Ishikawa, Akiyoshi Tsuboi, Hidenori Tanaka, Ken Yamashita, Yuichi Hiyama,
Cancers.2024; 16(19): 3271. CrossRef
Comparing efficacy and factors of postoperative bleeding in endoscopic mucosal resection vs coagulation for intestinal polyps
Zhiang Li, Fei Yu, Chaoqian Wang, Zhang Du
Medicine.2023; 102(37): e34941. CrossRef
“Unresectable” polyp management utilizing advanced endoscopic techniques results in high rate of colon preservation
Carey J. Wickham, Jennifer Wang, Kasim L. Mirza, Erik R. Noren, Joongho Shin, Sang W. Lee, Kyle G. Cologne
Surgical Endoscopy.2022; 36(3): 2121. CrossRef
Potential Factors Predicting Histopathologically Upgrade Discrepancies between Endoscopic Forceps Biopsy of the Colorectal Low-Grade Intraepithelial Neoplasia and Endoscopic Resection Specimens
Junbo Hong, Yining Wang, Jiangshan Deng, Miao Qi, Wei Zuo, Yuanzheng Hao, Anjiang Wang, Yi Tu, Shan Xu, Xiaodong Zhou, Xiaojiang Zhou, Guohua Li, Liang Zhu, Xu Shu, Yin Zhu, Nonghua Lv, Youxiang Chen, Li-kang Sun
BioMed Research International.2022; 2022: 1. CrossRef
Endoscopic vs optical biopsy for patients with colorectal lesions: prospective multicentral trial
K.D. Khalin, M.Yu. Agapov, E.D. Fedorov, L.V. Zvereva, N.E. Ogurchyonok, K.V. Stegnii, E.V. Ivanova, E.R. Dvoinikova, E.V. Gorbachev
Dokazatel'naya gastroenterologiya.2022; 11(3): 11. CrossRef
Long-term Outcomes of Primary Endoscopic Resection vs Surgery for T1 Colorectal Cancer: A Systematic Review and Meta-analysis
Jen-Hao Yeh, Cheng-Hao Tseng, Ru-Yi Huang, Chih-Wen Lin, Ching-Tai Lee, Po-Jen Hsiao, Tsung-Chin Wu, Liang-Tseng Kuo, Wen-Lun Wang
Clinical Gastroenterology and Hepatology.2020; 18(12): 2813. CrossRef
Prophylactic endoscopic coagulation to prevent delayed post-EMR bleeding in the colorectum: a prospective randomized controlled trial (with videos)
Hyun Seok Lee, Seong Woo Jeon, Yong Hwan Kwon, Su Youn Nam, Seonghwan Shin, Ryanghi Kim, Sohyun Ahn
Gastrointestinal Endoscopy.2019; 90(5): 813. CrossRef

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Role of random biopsies in surveillance of dysplasia in ulcerative colitis patients with high risk of colorectal cancer: Sawan Bopanna, Maitreyee Roy, Prasenjit Das, S Dattagupta, V Sreenivas, V Pratap Mouli, Saurabh Kedia, Rajan Dhingra, Rajesh Pradhan, N Suraj Kumar, Dawesh P Yadav, Govind Makharia, Vineet Ahuja; Intest Res 2016;14(3):264-269. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.264

Abstract PDF PubReader ePub

Background/Aims

Recent data suggest that the incidence of ulcerative colitis (UC) related colorectal cancer (CRC) in India is similar to that of West. The optimum method for surveillance is still a debate. Surveillance with random biopsies has been the standard of care, but is a tedious process. We therefore undertook this study to assess the yield of random biopsy in dysplasia surveillance.

Methods

Between March 2014 and July 2015, patients of UC attending the Inflammatory Bowel Disease clinic at the All India Institute of Medical Sciences with high risk factors for CRC like duration of disease >15 years and pancolitis, family history of CRC, primary sclerosing cholangitis underwent surveillance colonoscopy for dysplasia. Four quadrant random biopsies at 10 cm intervals were taken (33 biopsies). Two pathologists examined specimens for dysplasia, and the yield of dysplasia was calculated.

Results

Twenty-eight patients were included. Twenty-six of these had pancolitis with a duration of disease greater than 15 years, and two patients had associated primary sclerosing cholangis. No patient had a family history of CRC. The mean age at onset of disease was 28.89±8.73 years and the duration of disease was 19.00±8.78 years. Eighteen patients (64.28%) were males. A total of 924 biopsies were taken. None of the biopsies revealed any evidence of dysplasia, and 7/924 (0.7%) were indefinite for dysplasia.

Conclusions

Random biopsy for surveillance in longstanding extensive colitis has a low yield for dysplasia and does not suffice for screening. Newer techniques such as chromoendoscopy-guided biopsies need greater adoption.

Citations

Citations to this article as recorded by

Etrolizumab as an induction and maintenance therapy for ulcerative colitis: A systematic review and meta‐analysis of randomized controlled trials
Othman Saleh, Mohamed T. Abuelazm, Islam Mohamed, Alaa Ramadan, Mohammad Assaf, Ahmad Alzoubi, Majd M. AlBarakat, Basel Abdelazeem
JGH Open.2024;[Epub] CrossRef
Low prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease in India
Arshdeep Singh, Vandana Midha, Vikram Narang, Saurabh Kedia, Ramit Mahajan, Pavan Dhoble, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Ashish Tripathi, Shivam Kalra, Narender Pal Jain, Namita Bansal, Rupa Banerjee, Devendra Desai, Usha Dutta, Vineet Ahuja
Intestinal Research.2023; 21(4): 452. CrossRef
Colorectal Cancer Surveillance in Patients with Inflammatory Bowel Diseases: Chromoendoscopy or Non-Chromoendoscopy, That Is the Question
Roberto Gabbiadini, Ferdinando D’Amico, Alessandro De Marco, Maria Terrin, Alessandra Zilli, Federica Furfaro, Mariangela Allocca, Gionata Fiorino, Silvio Danese
Journal of Clinical Medicine.2022; 11(3): 509. CrossRef
Endoscopic Surveillance in Inflammatory Bowel Diseases: Selecting a Suitable Technology
Arianna Dal Buono, Roberto Gabbiadini, Federica Furfaro, Marjorie Argollo, Thaís Viana Tavares Trigo, Alessandro Repici, Giulia Roda
Frontiers in Medicine.2022;[Epub] CrossRef
Heterogeneity of Colorectal Cancer Progression: Molecular Gas and Brakes
Federica Gaiani, Federica Marchesi, Francesca Negri, Luana Greco, Alberto Malesci, Gian Luigi de’Angelis, Luigi Laghi
International Journal of Molecular Sciences.2021; 22(10): 5246. CrossRef
Histopathological study of endoscopic biopsies of large intestine
Manjiri N Karandikar, Purva Kulkarni, Smita Mulay, R C Nimbergi, N S Mani
Indian Journal of Pathology and Oncology.2021; 8(3): 340. CrossRef
Is histological remission of ulcerative colitis achievable?
Oleg V. Knyazev, Anna V. Kagramanova, Sergei G. Khomeriki, Asfold I. Parfenov
Terapevticheskii arkhiv.2021; 93(8): 975. CrossRef
A Systematic Review and Meta-Analysis on the Association between Inflammatory Bowel Disease Family History and Colorectal Cancer
Hadis Najafimehr, Hamid Asadzadeh Aghdaei, Mohamad Amin Pourhoseingholi, Hamid Mohaghegh Shalmani, Amir Vahedian-Azimi, Matthew Kroh, Mohammad Reza Zali, Amirhossein Sahebkar, Muhammad Naeem
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef
Safety and effectiveness of adalimumab in the treatment of ulcerative colitis: results from a large-scale, prospective, multicenter, observational study
Haruhiko Ogata, Takashi Hagiwara, Takeshi Kawaberi, Mariko Kobayashi, Toshifumi Hibi
Intestinal Research.2021; 19(4): 419. CrossRef
Histological remission of ulcerative colitis with combined anti-cytokine and cell therapy
Oleg V. Knyazev, Sergey G. Khomeriki, Аnna V. Kagramanova, Albina A. Lishchinskaya, Olga A. Smirnova, Karina K. Noskova, Asfold I. Parfenov
Terapevticheskii arkhiv.2021; 93(12): 1435. CrossRef
Discovery and Validation of Methylation Biomarkers for Ulcerative Colitis Associated Neoplasia
Andrew D Beggs, Jonathan James, Germaine Caldwell, Toby Prout, Mark P Dilworth, Phillipe Taniere, Tariq Iqbal, Dion G Morton, Glenn Matthews
Inflammatory Bowel Diseases.2018; 24(7): 1503. CrossRef
Can histologic remission be a better prognostic factor and therapeutic target beyond endoscopic mucosal healing in patients with ulcerative colitis?
Hyo Jun Ahn, Sang-Bum Kang
Intestinal Research.2018; 16(1): 1. CrossRef
The Rising Incidence of Younger Patients With Colorectal Cancer: Questions About Screening, Biology, and Treatment
Louise C. Connell, José Mauricio Mota, Maria Ignez Braghiroli, Paulo M. Hoff
Current Treatment Options in Oncology.2017;[Epub] CrossRef
Screening strategy for colorectal cancer according to risk
Dong Soo Han
Journal of the Korean Medical Association.2017; 60(11): 893. CrossRef

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The Clinical Usefulness of Endoscopic Ultrasound-Guided Fine Needle Aspiration and Biopsy for Rectal and Perirectal Lesions: Jae Seung Soh, Ho-Su Lee, Seohyun Lee, Jungho Bae, Hyo Jeong Lee, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Jeong-Sik Byeon; Intest Res 2015;13(2):135-144. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.135

Abstract PDF PubReader

Background/Aims

Endoscopic ultrasound-guided fine needle aspiration and/or biopsy (EUS-FNA/B) have been used to diagnose subepithelial tumors (SETs) and extraluminal lesions in the gastrointestinal tract. Our group previously reported the usefulness of EUS-FNA/B for rectal and perirectal lesions. This study reports our expanded experience with EUS-FNA/B for rectal and perirectal lesions in terms of diagnostic accuracy and safety. We also included our new experience with EUS-FNB using the recently introduced ProCore needle.

Methods

From April 2009 to March 2014, EUS-FNA/B for rectal and perirectal lesions was performed in 30 consecutive patients. We evaluated EUS-FNA/B performance by comparing histological diagnoses with final results. We also investigated factors affecting diagnostic accuracy.

Results

Among 10 patients with SETs, EUS-FNA/B specimen results revealed a gastrointestinal stromal tumor in 4 patients and malignant lymphoma in 1 patient. The diagnostic accuracy of EUS-FNA/B was 50% for SETs (5/10). Among 20 patients with non-SET lesions, 8 patients were diagnosed with malignant disease and 7 were diagnosed with benign disease based on both EUS-FNA/B and the final results. The diagnostic accuracy of EUS-FNA/B for non-SET lesions was 75% (15/20). The size of lesions was the only factor related to diagnostic accuracy (P=0.027). Two complications of mild fever and asymptomatic pneumoperitoneum occurred after EUS-FNA/B.

Conclusions

The overall diagnostic accuracy of EUS-FNA/B for rectal and perirectal lesions was 67% (20/30). EUS-FNA/B is a clinically useful method for cytological and histological diagnoses of rectal and perirectal lesions.

Citations

Citations to this article as recorded by

Colonoscopic Ultrasound-Guided Fine-Needle Aspiration Using a Curvilinear Array Transducer: A Single-Center Retrospective Cohort Study
Spencer Cheng, Sergio E. Matuguma, Guilherme H. P. de Oliveira, Gustavo L.R. Silva, Henrique Cheng, Sergio A. Sánchez-Luna, Mauricio K Minata
Diseases of the Colon & Rectum.2022; 65(2): e80. CrossRef
Diagnosis and Management of Rectal Neuroendocrine Tumors (NETs)
Francesco Maione, Alessia Chini, Marco Milone, Nicola Gennarelli, Michele Manigrasso, Rosa Maione, Gianluca Cassese, Gianluca Pagano, Francesca Paola Tropeano, Gaetano Luglio, Giovanni Domenico De Palma
Diagnostics.2021; 11(5): 771. CrossRef
Long-term experience with percutaneous biopsies of pelvic lesions using CT guidance
Petr Hoffmann, Michal Balik, Martina Hoffmannova, Jiri Spacek, Jiri Vanasek, Adam Rezac, Petr Dvorak
Science Progress.2021;[Epub] CrossRef
Prospective histological evaluation of a 20G core trap with a forward-cutting bevel needle for EUS-FNA of pancreatic lesions
Nobu Nishioka, Takeshi Ogura, Yoshitaka Kurisu, Miyuki Imanishi, Saori Onda, Wataru Takagi, Tatsushi Sano, Atsushi Okuda, Akira Miyano, Mio Amano, Kazuhide Higuchi
Surgical Endoscopy.2018; 32(10): 4125. CrossRef
Concise review on the comparative efficacy of endoscopic ultrasound-guided fine-needle aspiration vs core biopsy in pancreatic masses, upper and lower gastrointestinal submucosal tumors
Tawfik Khoury, Wisam Sbeit, Nicholas Ludvik, Divya Nadella, Alex Wiles, Caitlin Marshall, Manoj Kumar, Gilad Shapira, Alan Schumann, Meir Mizrahi
World Journal of Gastrointestinal Endoscopy.2018; 10(10): 267. CrossRef
Endoscopic ultrasound-guided fine needle aspiration of extra-rectal lesions
J. Lim, S. A. Norton, N. A. Wong, M. G. Thomas
Techniques in Coloproctology.2017; 21(5): 393. CrossRef
Application of Endoscopic Ultrasonography in the Diagnosis and Treatment of Lower Gastrointestinal Disease
Eun Young Kim
Intestinal Research.2015; 13(2): 101. CrossRef
Benign Prostatic Hyperplasia Mimicking a Symptomatic Rectal Submucosal Tumor
Seung Wook Hong, Jaeyoung Chun, Kyu Joo Park, Cheol Kwak, Joo Sung Kim
Soonchunhyang Medical Science.2015; 21(2): 164. CrossRef

6,496 View
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