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논문 기본 정보

자료유형
학술저널
저자정보
Dong-Hoon Yang (Asan Medical Center) Sneha John (Gold Coast University Hospital Southport Australia) Fujishiro Mitsuhiro (Nagoya University Graduate School of Medicine) Jae Myung Cha (Kyung Hee University School of Medicine) Jeong-Sik Byeon (Asan Medical Center) Hyung Wook Kim (Pusan National University School of Medicine) Hyun Gun Kim (Soonchunhyang University College of Medicine) Shai Friedland (Stanford University School of Medicine) Yon Xian Koh (Gold Coast University Hospital Southport Australia) Jin-Young Yoon (Kyung Hee University School of Medicine) Min-Seob Kwak (Kyung Hee University School of Medicine) Byong Duk Ye (Asan Medical Center) Jihun Kim (University of Ulsan College of Medicine) Suk-Kyun Yang (Asan Medical Center)
저널정보
거트앤리버 발행위원회 Gut and Liver Gut and Liver 제14권 제5호
발행연도
2020.1
수록면
611 - 618 (8page)

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Background/Aims: Endoscopic diagnosis of dysplasia or colitic cancer in patients with ulcerative colitis (UC) is more challenging than that of colorectal neoplasia in non-colitic patients. We aimed to evaluate the accuracy of the endoscopic diagnosis of “nonpedunculated” dysplasia or colitic cancer in UC patients. Methods: Ten endoscopists from four countries were surveyed using photographs of 61 histologically confirmed dysplastic or non-dysplastic lesions retrieved from the UC registry database of Asan Medical Center. The participants provided their assessment based on the given photographs and their intention to perform biopsy. Results: The overall diagnostic performance of the 10 participants is summarized as follows: sensitivity of 88.2% (95% confidence interval [CI], 84.3% to 91.5%), specificity of 34.8% (95% CI, 29.1% to 40.8%), positive predictive value of 63.0% (95% CI, 60.8% to 65.2%), negative predictive value of 70.2% (95% CI, 62.7% to 76.6%), and accuracy of 64.6% (95% CI, 60.7% to 68.4%). The interobserver agreement on the intention to perform a biopsy was poor (Fleiss kappa=0.169). Of the three endoscopic characteristics of the lesions, including ulceration, distinctness of the borders, and pit patterns, only neoplastic pit patterns were significantly predictive of dysplasia (odds ratio, 3.710; 95% CI, 2.001 to 6.881). The diagnostic sensitivity and specificity of neoplastic pit patterns were 68.2% (95% CI, 63.0% to 73.2%) and 63.3% (95% CI, 57.3% to 69.1%), respectively. Conclusions: Diagnostic performance based on the endoscopist’s intention to perform a biopsy for nonpedunculated potentially dysplastic lesions in UC patients was suboptimal according to this survey-based study.
#Colitis #ulcerative #Dysplasia #Neoplasm #colonic #Colonoscopy #Diagnosis

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참고문헌 (22)

참고문헌 신청
Jess T / 2012 / Risk of colorectal cancer in patients with ulcerative colitis : a meta-analysis of populationbased cohort studies / Clin Gastroenterol Hepatol 10:639~645 google schola Ruben J. Colman / 2016 / Histological inflammation increases the risk of colorectal neoplasia in ulcerative colitis: a systematic review / Intestinal research 14(3):202~210 dbpia Annese V / 2013 / European evidence based consensus for endoscopy in inflammatory bowel disease / J Crohns Colitis 7:982~1018 google schola Farraye FA / 2010 / AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease / Gastroenterology 138:738~745 google schola American Society for Gastrointestinal Endoscopy Standards of Practice Committee / 2015 / The role of endoscopy in inflammatory bowel disease / Gastrointest Endosc 81:1101~1121 google schola

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