Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 3;6(1):37-41.
doi: 10.1093/jcag/gwac024. eCollection 2023 Feb.

Pancolonic Dye Spray Chromoendoscopy to Detect and Resect Ill-Defined Neoplastic Lesions in Colonic Inflammatory Bowel Disease

Claudia Dziegielewski  1 , Sarang Gupta  2 , Jeffrey D McCurdy  1   3   4 , Richmond Sy  1   3   4 , Navaaz Saloojee  1   3 , Sanjay K Murthy  1   3   4
Affiliations

Pancolonic Dye Spray Chromoendoscopy to Detect and Resect Ill-Defined Neoplastic Lesions in Colonic Inflammatory Bowel Disease

Claudia Dziegielewski et al. J Can Assoc Gastroenterol. .

Abstract

Background: Pancolonic dye spray chromoendoscopy (DCE) is used as an adjunct to white light endoscopy (WLE) to enhance the detection and delineation of ill-defined neoplastic (dysplastic) lesions in persons with colonic inflammatory bowel diseases (cIBD). We evaluated the utility of DCE as follow-up to high-definition WLE (HD-WLE) to "unmask" and/or facilitate endoscopic resection of neoplastic lesions.

Methods: We retrospectively studied persons with cIBD who underwent DCE as follow-up to HD-WLE between 2013 and 2020. We describe neoplastic findings and management during HD-WLE and DCE exams and report outcomes from post-DCE surveillance exams.

Results: Twenty-four persons were studied (mean age 56.7 ± 13.8 years, 50.0% male, 70.8% ulcerative colitis, mean disease duration 18.0 ± 11.0 years). Overall, 32 visible neoplastic lesions were unmasked during DCE, of which 24 were endoscopically resected. DCE facilitated the diagnosis of two cancers. Among 17 persons referred for evaluation of "invisible" neoplasia (detected in non-targeted biopsies) during HD-WLE, DCE identified neoplastic lesions at the same site in eight persons and a different site in four persons. Among seven persons referred for ill-defined visible neoplasia, DCE facilitated complete endoscopic resection in four individuals, whereas two individuals required colectomy for a diagnosis of cancer. Among 19 individuals with post-DCE surveillance, five developed new visible neoplastic lesions, including one high-grade neoplasia which was completely resected.

Conclusions: In our cohort, DCE aided in unmasking invisible neoplasia and facilitated endoscopic resection of ill-defined neoplasia, suggesting that it is a useful surveillance tool in selected persons with cIBD. Large prospective studies are needed to validate these findings.

Keywords: Chromoendoscopy; Colonoscopy; Crohn’s disease; Dye spray; Dysplasia; Inflammatory bowel disease; Neoplasia; Screening; Surveillance; Ulcerative colitis; White light endoscopy.

PubMed Disclaimer

References

    1. Lutgens MW, van Oijen MG, van der Heijden GJ, et al. . Declining risk of colorectal cancer in inflammatory bowel disease: An updated meta-analysis of population-based cohort studies. Inflamm Bowel Dis. 2013;19:789–99. doi:10.1097/MIB.0b013e31828029c0. - DOI - PubMed
    1. Herrinton LJ, Liu L, Levin TR, et al. . Incidence and mortality of colorectal adenocarcinoma in persons with inflammatory bowel disease from 1998 to 2010. Gastroenterology 2012;143:382–9. doi:10.1053/j.gastro.2012.04.054. - DOI - PubMed
    1. Bernstein CN, Blanchard JF, Kliewer E, et al. . Cancer risk in patients with inflammatory bowel disease: A population-based study. Cancer 2001;91:854–62. doi:10.1002/1097-0142(20010215)91:4<854::aid-cncr1073>3.0.co;2-z. - DOI - PubMed
    1. Shah SC, Itzkowitz SH.. Colorectal cancer in inflammatory bowel disease: Mechanisms and management. Gastroenterology 2022;162:715–30.e3. - PMC - PubMed
    1. Lee H, Rabinovitch PS, Mattis AN, et al. . Non-conventional dysplasia in inflammatory bowel disease is more frequently associated with advanced neoplasia and aneuploidy than conventional dysplasia. Histopathology 2021;78:814–30. - PubMed

LinkOut - more resources