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Endoscopic and chromoendoscopic atlas featuring dysplastic lesions in surveillance colonoscopy for patients with long-standing ulcerative colitis

Matsumoto, Takayuki1; Iwao, Yasushi2; Igarashi, Masahiro3; Watanabe, Kenji4; Otsuka, Kazuo5; Watanabe, Toshiaki6; Iizuka, Bunei7; Hida, Nobuyuki1; Sada, Miwa8; Chiba, Toshimi9; Kudo, Shin-Ei5; Oshitani, Nobuhide4; Nagawa, Hirokazu10; Ajioka, Yoichi11; Hibi, Toshifumi2

doi: 10.1002/ibd.20267
Clinical Reviews: Endoscopic Atlas for Dysplasia in UC: Clinical Review

Clinical and epidemiological studies have revealed that the incidence of colorectal cancer associated with ulcerative colitis increases with long-term chronic inflammation. Careful endoscopic observation and histological studies to check for dysplasia in the colon are important in detecting neoplasia. Current surveillance protocols mainly involve frequent step biopsies to yield a reasonable rate of dysplasia detection. However, recent studies using chromoendoscopy or magnifying endoscopy have proposed that neoplastic changes may be detected efficiently. Therefore, it is very important to understand the typical endoscopic findings found in neoplastic changes in patients proven to have long-standing ulcerative colitis. In this review, we demonstrate the typical endoscopic findings by conventional endoscopy and chromoendoscopy.

1Department of Lower Gastroenterology, Hyogo College of Medicine, Nishinomiya, Japan

2Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan

3Endoscopy Division, Cancer Institute Hospital, Tokyo, Japan

4Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan

5Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan

6Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan

7Department of Gastroenterology, Tokyo Women's Medical School, Tokyo, Japan

8Department of Gastroenterology, Kitasato University East Hospital, Sagamihara, Japan

9First Department of Internal Medicine, Iwate Medical University, Iwate, Japan

10Department of Surgical Oncology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

11Division of Molecular and Diagnostic Pathology, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata, Japan

Received 2 August 2007; Accepted 6 August 2007

Published online 31 October 2007 in Wiley Online Library (

Grant sponsor: Japanese Ministry of Welfare and Labor (to T.H. and Research Group for Intractable Inflammatory Bowel Disease).

© Crohn's & Colitis Foundation of America, Inc.
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