|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