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用于炎症性肠病发育异常监测的色素内镜检查的应用及障碍

Use and barriers to chromoendoscopy for dysplasia surveillance in inflammatory bowel disease.

作者信息

Shukla Richa, Salem Mark, Hou Jason K

机构信息

Richa Shukla, Mark Salem, Jason K Hou, Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, United States.

出版信息

World J Gastrointest Endosc. 2017 Aug 16;9(8):359-367. doi: 10.4253/wjge.v9.i8.359.

Abstract

Traditionally, patients with inflammatory bowel disease (IBD) have been thought to be at increased risk of developing colitis-associated colorectal cancer. Although there are recent data suggesting that rates of colitis-associated cancer in IBD patients is declining, current guidelines still recommend regular dysplasia surveillance for early detection and prevention of neoplasia in patients with IBD. White-light endoscopy with random biopsies has been the traditional approach for dysplasia detection; however, newer technologies and approaches have emerged. One method, dye-based chromoendoscopy, has the potential to detect more dysplasia. However, longitudinal data to showing a benefit in morbidity or mortality from the use of chromoendoscopy are still lacking. Many societies have included recommendation on the use of chromoendoscopy with targeted biopsies as a method of surveillance for colitis - associated colorectal cancer. This narrative review seeks to outline data on dysplasia detection as well as barriers to the implementation of dye-based chromoendoscopy for the prevention and early detection of colitis-associated colorectal cancer.

摘要

传统上,炎症性肠病(IBD)患者被认为患结肠炎相关结直肠癌的风险增加。尽管最近有数据表明IBD患者中结肠炎相关癌症的发病率正在下降,但当前指南仍建议对IBD患者进行定期的发育异常监测,以便早期发现和预防肿瘤形成。白光内镜随机活检一直是检测发育异常的传统方法;然而,更新的技术和方法已经出现。一种方法是基于染料的色素内镜检查,它有可能检测到更多的发育异常。然而,仍缺乏纵向数据来证明使用色素内镜检查在发病率或死亡率方面的益处。许多学会已将关于使用色素内镜检查并进行靶向活检作为监测结肠炎相关结直肠癌的一种方法纳入建议。本叙述性综述旨在概述有关发育异常检测的数据,以及基于染料的色素内镜检查在预防和早期检测结肠炎相关结直肠癌方面实施的障碍。

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