The histological variability in colitis-associated colorectal cancer and the association to clinical factors is unknown.
Dr Stephan Brackmann and colleagues from Norway evaluated 67 patients with colorectal cancer in inflammatory bowel disease.
The team assessed histopathology of the cancers and tissue samples from different colorectal localizations, and analyzed relationships to clinical factors.
The team found that 75% showed dysplasia in the colorectum apart from the cancer, while 25% had no dysplasia at cancer diagnosis.
Mean age at onset of inflammatory bowel disease was 22 years in patients with, and 34 years in patients without dysplasia.
The team found that the mean duration of colitis-colorectal cancer interval was 21 years in patients with and 16 years in patients without dysplasia.
The latter group included all patients with a colitis-colorectal cancer interval was less than 10 years.
|75% showed dysplasia in the colorectum apart from the cancer|
|Inflammatory Bowel Diseases |
The researchers found that active inflammation was more likely to occur in patients with dysplasia.
The 2 groups were not discriminated by gender, family history of colorectal cancer or inflammatory bowel disease.
In addition, the team noted that the 2 groups were not discriminated by medical treatment, active symptoms, or histological features like type of cancer and differentiation.
In multiple logistic regression analysis the age at onset of inflammatory bowel disease was the strongest predictive variable for dysplasia at cancer diagnosis.
Dr Brackmann’s team concluded, “Widespread neoplasia occurs in the majority of cases with colorectal cancer in inflammatory bowel disease and is associated with early onset of inflammatory bowel disease.”
“Localized neoplasia occurs in about a quarter of the patients and shows an association with late-onset inflammatory bowel disease.”
“The 2 groups probably represent different pathogenetic entities of neoplasia in inflammatory bowel disease.”
“This might have consequences for surveillance strategies.”