期刊
DIGESTIVE AND LIVER DISEASE
卷 53, 期 7, 页码 846-851出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.dld.2020.09.024
关键词
Advanced endoscopic imaging; Chronic non-bloody diarrhea; Collagenous colitis; Colorectal adenoma; Colorectal cancer; Lymphocytic colitis; Microscopic colitis
资金
- Italian Society of Gastroenterology (Premio SIGE)
This multi-center study confirms MC as a low-risk condition for colorectal neoplasia, suggesting no need for surveillance colonoscopy program for MC diagnosis.
Background and Aims: Microscopic colitis (MC) is the most frequent condition in subjects undergoing ileocolonoscopy for chronic non-bloody diarrhea (CNBD) in Western countries. Emerging evidence has shown a negative association between MC and colorectal cancer. Within this prospective multi-center study we have evaluated the risk of colorectal neoplasia in MC and non-MC patients with CNBD receiving ileocolonoscopy with high-definition plus virtual chromoendoscopic imaging and histopathological assessment. Methods: Patients with CNBD of unknown origin were prospectively enrolled in 5 referral centers in Northern Italy for ileocolonoscopy with high-definition and digital/optical chromoendoscopy plus multiple biopsies in each segment. The prevalence of colorectal neoplasia (cancer, adenoma, serrated lesion) in MC was compared to that observed in a control group including CNBD patients negative for MC, inflammatory bowel disease or eosinophilic colitis. Results: From 2014 and 2017, 546 consecutive CNBD patients were recruited. Among the 492 patients (mean age 53 +/- 18 years) fulfilling the inclusion criteria against the exclusion critieria, MC was the predominant diagnosis at histopathological assessment (8.7%: N = 43, 28 CC, 15 LC). The regression model adjusted for age and gender showed a significant negative association between the diagnosis of CM and colorectal neoplasia (OR = 0.39; 95% CI 0.22 & minus;0.67, p < 0.001) with a 60% decreased risk of adenomatous and neoplastic serrated polyps as compared to the control group ( n = 412). Conclusion: This multi-center study confirms MC as a low-risk condition for colorectal neoplasia. No surveillance colonoscopy program is to be performed for MC diagnosis. (c) 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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