Universität zu Köln

Leifeld, Ludger, Rogler, Gerhard ORCID: 0000-0002-1733-9188, Stallmach, Andreas, Schmidt, Carsten, Zuber-Jerger, Ina, Hartmann, Franz, Plauth, Mathias, Drabik, Attyla ORCID: 0000-0001-8413-7626, Hofstaedter, Ferdinand, Dienes, Hans Peter and Kruis, Wolfgang (2015). White-Light or Narrow-Band Imaging Colonoscopy in Surveillance of Ulcerative Colitis: A Prospective Multicenter Study. Clin. Gastroenterol. Hepatol., 13 (10). S. 1776 - 1783. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1542-7714

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Abstract

BACKGROUND & AIMS: Early detection of neoplastic lesions is essential in patients with long-standing ulcerative colitis but the best technique of colonoscopy still is controversial. METHODS: We performed a prospective multicenter study in patients with long-standing ulcerative colitis. Two colonoscopies were performed in each patient within 3 weeks to 3 months. In white-light (WL) colonoscopy, stepwise random biopsy specimens (4 biopsy specimens every 10 cm), segmental random biopsies (2 biopsy specimens in 5 segments), and targeted biopsy specimens were taken. In NBI colonoscopy, segmental and targeted biopsy specimens were taken. The sequence of WL and NBI colonoscopy was randomized. RESULTS: In 36 of 159 patients enrolled (22.6%), 54 lesions with intraepithelial neoplasia (IN) were found (51 low-grade, 3 high-grade). In WL colonoscopy we found 11 IN in stepwise biopsy specimens, 4 in segmental biopsy specimens, and 15 in targeted biopsy specimens. In NBI colonoscopy 7 IN were detected in segmental biopsy specimens and 24 IN were detected in targeted biopsy specimens. Almost all IN were found with one technique alone (kappa value of WL vs NBI, -0.86; P < .001). Statistically equivalent numbers of IN were found in NBI colonoscopy with targeted and segmental biopsy specimens as in WL colonoscopy with targeted and stepwise biopsy specimens, but with fewer biopsy specimens (11.9 vs 38.6 biopsy specimens, respectively; P < .001), and less withdrawal time was necessary (23 vs 13 min, respectively; P < .001). CONCLUSIONS: Stepwise biopsy specimens are indispensable in WL colonoscopy. The combination of targeted and segmental biopsy specimens in the NBI technique is as sensitive as targeted together with stepwise biopsy specimens in WL colonoscopy, but requires fewer biopsy specimens and less time. The highest sensitivity should be reached by combining the WL and NBI techniques by switching between the modes.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Leifeld, Ludger UNSPECIFIED UNSPECIFIED UNSPECIFIED Rogler, Gerhard UNSPECIFIED orcid.org/0000-0002-1733-9188 UNSPECIFIED Stallmach, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Zuber-Jerger, Ina UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartmann, Franz UNSPECIFIED UNSPECIFIED UNSPECIFIED Plauth, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED Drabik, Attyla UNSPECIFIED orcid.org/0000-0001-8413-7626 UNSPECIFIED Hofstaedter, Ferdinand UNSPECIFIED UNSPECIFIED UNSPECIFIED Dienes, Hans Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Kruis, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-391639
DOI:	10.1016/j.cgh.2015.04.172
Journal or Publication Title:	Clin. Gastroenterol. Hepatol.
Volume:	13
Number:	10
Page Range:	S. 1776 - 1783
Date:	2015
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1542-7714
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MAGNIFICATION CHROMOSCOPIC-COLONOSCOPY; INFLAMMATORY-BOWEL-DISEASE; INTRAEPITHELIAL NEOPLASIA; METHYLENE-BLUE; CANCER SURVEILLANCE; COLON-CANCER; DNA-DAMAGE; DYSPLASIA; CHROMOENDOSCOPY; DIAGNOSIS Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39163