Saudi Journal of Gastroenterology
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Year : 2014  |  Volume : 20  |  Issue : 1  |  Page : 26-38

Advanced endoscopic imaging for surveillance for dysplasia and colorectal cancer in inflammatory bowel disease: Could the pathologist be further helped?


1 PhD Course in Surgical Biotechnology and Regenerative Medicine, University of Palermo, via Trabucco 180, 90146 Palermo; Ospedale San Raffaele - Giglio, Gastroenterology and Endoscopy Unit, Cefal¨, Italy
2 DICHIRONS Department, School of Medicine, University of Palermo, via Trabucco 180, 90146 Palermo, Italy
3 Ospedale San Raffaele - Giglio, Gastroenterology and Endoscopy Unit, Cefal¨, Italy
4 Krankenhaus Waldfriede, Akademisches Lehrkrankenhaus DER Charite, Argentinische Allee 40, 14163 Berlin, Germany
5 Ospedali Riuniti Villa Sofia - Cervello, Unit of Gastroenterology, via Trabucco 180, 90146 Palermo, Italy
6 Ospedale San Raffaele - Giglio, Unit of Oncology, Cefal¨, Italy
7 AOUP Paolo Giaccone, School of Medicine, University of Palermo, via Trabucco 180, 90146 Palermo, Italy
8 Centro Diagnostico MarasÓ SRL, Palermo, Italy
9 DIBIMIS Department, Ospedali Riuniti Villa Sofia - Cervello, Unit of Internal Medicine, via Trabucco 180, 90146 Palermo, Italy

Correspondence Address:
Emanuele Sinagra
Via Degli orti 41, 90143 Palermo
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1319-3767.126314

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Patients with inflammatory bowel disease (IBD) have an increased risk of developing intestinal cancer. The magnitude of that increased risk as well as how best to mitigate it remain a topic of ongoing investigation in the field. It is important to quantify the risk of colorectal cancer in association with IBD. The reported risk varies widely between studies. This is partly due to the different methodologies used in the studies. Because of the limitations of surveillance strategies based on the detection of dysplasia, advanced endoscopic imaging and techniques involving the detection of alterations in mucosal antigens and genetic abnormalities are being investigated. Development of new biomarkers, predicting future occurrence of colonic neoplasia may lead to more biomarker-based surveillance. There are promising results that may lead to more efficient surveillance in IBD patients and more general acceptance of its use. A multidisciplinary approach, involving in particular endoscopists and pathologists, together with a centralized patient management, could help to optimize treatments and follow-up measures, both of which could help to reduce the IBD-associated cancer risk.


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