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International Session (Symposium)9 (JGES・JSGE・JSGS)
Sat. October 14th   14:40 - 17:00   Room 11: Fukuoka International Congress Center 502+503
Comparison with newly-developed NBI and panchromoendoscopy for surveillance colonoscopy in patients with longstanding ulcerative colitis: A sub-analysis of Navigator Study
K. Watanabe1, M. Nishishita2, F. Shimamoto3
1Department of Intestinal Inflammation Research, Hyogo College of Medicine, 2Nishishita Gastrointestinal Hospital, 3Faculty of Human Culture and Science Prefectural University of Hiroshima
Background: We recently reported the results of a prospective, randomized controlled trial comparing newly-developed NBI (CF-HQ290I) and panchromoendoscopy for surveillance colonoscopy in patients with ulcerative colitis (UC). The results revealed pancolonic newly-developed NBI observation was not inferior to panchromoendoscopy for the detection both of neoplastic lesions and colitis associated dysplasia or cancer (CC/D), and observation time of NBI was significantly shorter than panchromoendoscopy. This sub-analysis aims to evaluate the relevant factors or NBI findings of background mucosa for neoplastic lesions in the Navigator Study (UMIN000013527).
Methods: Pathological diagnoses were performed by 2 expert pathologist using immunohistochemical staining in a blinded manner for the clinical information. A total of 263 patients were randomized to two groups.
Results: A total of 21 sporadic adenoma, 2 traditional serrated adenoma, 2 sessile serrated adenoma/polyp, 7 low grade dysplsisa and 7 high grade dysplasia or cancer. There was no statistical difference for the contents of detected lesions between two groups. Multivariate analysis showed past history of CC/D (OR=5.70, 95%CI 1.33-24.50, p=0.02) was relevant factor for the CC/D. CC/Ds were significantly higher detected in the background mucosa with obscure vascular pattern or scar than fair view of vascular pattern or out of range for inflammation (OR=25.0, 95%CI 3.80-164.4, p<0.01) compared with sporadic adenoma.
Conclusion: In Navigator Study, past history of endocopic resection or detection of dysplasia by using random biopsy was relevant factor for the detection of CC/D. NBI findings of background mucosa was useful to differentiate CC/D and sporadic adenoma.
Index Term 1: Narrow band imaging
Index Term 2: surveillance colonoscopy
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