Dr Michael Picco and colleagues compared colonoscopy alone with surveillance biopsy in determining anatomic extent in long-standing ulcerative colitis.
The researchers assessed the influences of mesalamine use and clinical disease activity on the change of histologic extent with time.
Disease extent measured by colonoscopy and surveillance biopsy was compared among 212 consecutive patients with long-standing ulcerative colitis.
Among 102 patients, 2 had consecutive colonoscopies with surveillance biopsies.
The research team determined influences on change in histologic extent disease activity, mesalamine use, age at disease onset, and folic acid.
Corticosteroid and azathioprine/6-mercaptopurine use, and time between colonoscopies was also measured.
The researchers found that agreement between gross and microscopic findings was poor.
|Oral mesalamine was associated with 6 times the odds of a decrease in disease extent |
|Inflammatory Bowel Diseases|
Colonoscopy underestimated and overestimated extent in 26% and 9%, respectively.
Microscopic distribution between consecutive colonoscopies remained the same in 61%.
The team observed that where distribution changed, an increase was twice as common as a decrease in extent.
There was no difference in age at onset, time between colonoscopies, or disease duration among those with an increase, decrease, or no change in extent.
The researchers noted that clinical remission, and oral mesalamine were independently associated with 11 and 6 times the odds of a decrease in disease extent, respectively.
Folic acid, topical mesalamine, corticosteroids, and immunomodulators did not influence change in extent.
Dr Picco's team commented, “Ulcerative colitis extent is best determined by surveillance biopsy.”
“Among patients with long-standing ulcerative colitis, histologic extent fluctuates with time.”
“Disease remission and oral mesalamine were independently associated with decreases in disease extent.”