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„precancer”︁ lesions in ulcerative colitis( A retrospective study of rectal biopsy and colectomy specimens )
Author(s) -
Yardley John H.,
Keren David F.
Publication year - 1974
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197409)34:3+<835::aid-cncr2820340709>3.0.co;2-t
Subject(s) - medicine , ulcerative colitis , colectomy , biopsy , colitis , retrospective cohort study , general surgery , gastroenterology , disease
To further define and determine the occurrence of the „precancer” lesion in patients with ulcerative colitis (UC), colectomy specimens and rectal biopsies from patients with UC from the files of The Johns Hopkins Hospital in the period 1962 to 1973 (41 resections and 412 rectal biopsies) were studied. Seven out of 8 resections containing carcinoma also showed flat or adenomatous mucosal lesions, characterized by the marked epithelial atypia, villous change, and reduced epithelial mucus content indicative of precancer. Similar precancerous changes were found in 3 of the 412 rectal biopsies studied. Two of these patients had subsequent colectomy with invasive carcinoma. The 3rd had diffuse precancerous changes throughout his colon in the form of multiple adenomas. It is concluded that precancer changes are valid means for identifying the population of UC patients at highest risk of developing carcinoma of the colon, and that some of these individuals can be discovered by using rectal biopsy. It was also clear, however, that active colitis (acute inflammation) artificially increased the number of biopsies showing changes suspicious of precancer. At the same time, bonafide cases of precancer involving other parts of the colon can go undetected by using only rectal biopsy. Those patients might be more successfully identified by using colonoscopy, combined with biopsy at regular intervals in individuals with UC who are known on clinical grounds to be especially likely to develon carcinoma.