Risk for colorectal neoplasia in patients with inflammatory bowel disease and mucosa indefinite for dysplasia

Keith K. Lai, Bela Horvath, Hao Xie, Xianrui Wu, Brian L. Lewis, Rish Pai, Thomas Plesec, Deepa T. Patil, Ilyssa O. Gordon, Yinghong Wang, Bo Shen, John R. Goldblum, Xiuli Liu

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background: The management of colonic epithelial changes indefinite for dysplasia (IND) in patients with inflammatory bowel disease (IBD) remains controversial because of a paucity of published outcome data. Methods: We analyzed data from 93 patients with IBD who were IND and 52 IBD patients without dysplasia (controls) from the Department of Anatomic Pathology database at the Cleveland Clinic from 1989 to 2004. Pathology reports, histologic slides, clinical features, and outcomes were reviewed. Results: Twenty-two patients (23.7%) had surgical resections within 6 months of the IND assignment; of these, 6 had dysplasia (27.3%; 1 low-grade dysplasia and 5 high-grade dysplasia [HGD]). The remaining 71 patients received regular colonoscopy examinations for a mean period of 98.6 months; 18 patients developed dysplasia or carcinoma (25.2%; 10 low-grade dysplasia, 5 HGD, and 3 colorectal cancer). There was a mean interval of 53.9 months between an IND assignment and identification of dysplasia or carcinoma. Histology review of 59 cases revealed 3.2 cases per 100 person-years for neoplasia (low-grade dysplasia, HGD, or colorectal cancer) and 1.5 cases per 100 person-years for advanced neoplasia (HGD or colorectal cancer); these values were higher than those for controls (1.9 cases per 100 person-years for neoplasia and 0.7 cases per 100 person-years for advance neoplasia; P = 0.1 and P = 0.2, respectively, for IND versus controls). Patients aged more than 44 years when they were found to be IND were more likely than younger patients to develop neoplasia (hazard ratio, 6.7; P = 0.01). Conclusions: Patients with IBD and IND are at significant risk for colorectal dysplasia and cancer. These patients should be closely followed.

Original languageEnglish (US)
Pages (from-to)378-384
Number of pages7
JournalInflammatory Bowel Diseases
Volume21
Issue number2
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Keywords

  • Colon cancer risk
  • Crohn's disease
  • Ulcerative colitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Gastroenterology

Fingerprint Dive into the research topics of 'Risk for colorectal neoplasia in patients with inflammatory bowel disease and mucosa indefinite for dysplasia'. Together they form a unique fingerprint.

  • Cite this

    Lai, K. K., Horvath, B., Xie, H., Wu, X., Lewis, B. L., Pai, R., Plesec, T., Patil, D. T., Gordon, I. O., Wang, Y., Shen, B., Goldblum, J. R., & Liu, X. (2015). Risk for colorectal neoplasia in patients with inflammatory bowel disease and mucosa indefinite for dysplasia. Inflammatory Bowel Diseases, 21(2), 378-384. https://doi.org/10.1097/MIB.0000000000000286