Although inflammation is presumed to contribute to colonic neoplasia in ulcerative colitis, few studies have directly examined this relationship.
Dr Roopali Bansal Gupta and colleagues from New York, USA determined whether severity of microscopic inflammation over time is an independent risk factor for neoplastic progression in ulcerative colitis .
|65 of 418 patients progressed to any neoplasia|
The research team studied a cohort of patients with ulcerative colitis undergoing regular endoscopic surveillance for dysplasia.
Degree of inflammation at each biopsy site had been graded as part of routine clinical care using a highly reproducible histologic activity index.
The team analyzed progression to neoplasia using proportional hazards models.
Inflammation was summarized in 3 different ways and was included as a time-changing covariate as a mean, binary and maximum inflammatory score.
Potential confounders were analyzed in univariate testing and, when significant, in a multivariable model.
The researchers included of 418 patients who met the criteria, of which 15 progressed to advanced neoplasia
The research team reported that 65 progressed to any neoplasia, including low-grade dysplasia, high-grade dysplasia, or colorectal cancer.
The team demonstrated significant relationships between histologic inflammation over time and progression to advanced neoplasia.
This association was maintained in multivariable proportional hazards analysis.
Dr Gupta's team concluded, "The severity of microscopic inflammation over time is an independent risk factor for developing advanced colorectal neoplasia among patients with long-standing ulcerative colitis."