Difference in the clinical characteristic and prognosis of colitis-associated cancer and sporadic neoplasia in ulcerative colitis patients

Makoto Mutaguchi, Makoto Naganuma, Shinya Sugimoto, Tomohiro Fukuda, Kosaku Nanki, Shinta Mizuno, Naoki Hosoe, Masayuki Shimoda, Haruhiko Ogata, Yasushi Iwao, Takanori Kanai

研究成果: Article

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Background: Although various studies have been conducted on colitis-associated cancer (CAC), few have assessed the differences in the clinical and endoscopic features, treatment, and prognosis of CAC and sporadic neoplasia (SN) in the inflamed mucosa of ulcerative colitis (UC) patients. Aims: To compare the characteristics of CAC and SN within the previously or currently inflamed mucosa. Methods: Between 1997 and 2017, we retrospectively analyzed the endoscopic chart data of 348 colonic lesions from 266 UC patients. Non-dysplastic lesions and lesions located outside the inflamed mucosa were excluded. The diagnosis of CAC or SN was confirmed by conventional histopathological and immunohistochemical evaluation of p53 and Ki67. Results: In total, 74 patients with CAC (97 lesions) and 46 with SN (58) were enrolled. The proportions of patients with a younger age of onset of UC, with chronic persistent UC, and with severe inflamed mucosa were significantly higher in the CAC group. In the SN group, no flat lesions were found, whereas 26% of the lesions in the CAC group were flat. Sixteen patients died during a median follow-up of 6.1 years (interquartile range (IQR) 1.8–11.1)in the CAC group, whereas 1 patient died during a median follow-up 3.2 years(IQR 1.4–4.6) in the SN group. Mortality from colorectal cancer was significantly higher (P = 0.015) in the CAC group (12/68; 17.6%) than in the SN group (1/44; 2.3%). The 5-year survival rate was 100% in the SN group and 97% in the CAC group for lesions located in the mucosa or submucosa. Conclusion: Recognizing differences in the characteristics of CAC and SN within the inflamed mucosa is critical to avoid unnecessary total colectomy in patients with SN.

元の言語English
ページ(範囲)1257-1264
ページ数8
ジャーナルDigestive and Liver Disease
51
発行部数9
DOI
出版物ステータスPublished - 2019 9

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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