A168 UTILITY OF FOLLOW-UP PANCOLONIC DYE SPRAY CHROMOENDOSCOPY FOR THE DETECTION AND TREATMENT OF DYSPLASTIC LESIONS IDENTIFIED DURING HIGH-DEFINITION WHITE-LIGHT ENDOSCOPY IN PATIENTS WITH COLONIC INFLAMMATORY BOWEL DISEASE
Notice bibliographique
Résumé
Abstract Background Patients with inflammatory bowel disease (IBD) involving the colorectum are at higher risk for the development of flat and poorly delineated dysplastic lesions. Pancolonic dye spray chromoendoscopy (DCE) can represent an adjunct to white light endoscopy (WLE) that enhances detection and delineation of such lesions. Aims We evaluated the utility of follow-up DCE for lesion detection and treatment in patients with IBD who had visible (polypoid or flat lesions) or invisible (identified in non-targeted biopsies) dysplasia detected during high-definition (HD)-WLE. Methods We retrospectively studied patients with colonic IBD from The Ottawa Hospital who underwent DCE by a trained endoscopist, as follow-up for dysplasia detected during HD-WLE, over a 7-year time period (2013–2020). We collected demographic and disease-specific variables. Results Twenty-four patients were included (mean age 56.7±13.8 years, 50.0% male, 70.8% ulcerative colitis, mean disease duration 18.0±11.0 years, 70.8% moderate or severe disease activity historically, and 41.7% remote history of dysplasia). Seventeen (70.8%) patients were referred following detection of invisible dysplasia; the remainder (29.2%) were referred for surveillance of poorly defined visible dysplastic lesions. For those referred following detection of invisible dysplasia, DCE identified visible dysplasia at the same site in 8/17 (47.1%) patients, at a different site in 6/17 (35.3%) patients, and no dysplasia in 3/17 (17.6%) patients. DCE identified 1.39±1.50 new visible dysplastic lesions per patient that were not identified on index HD-WLE. DCE upgraded the highest grade of dysplasia and diagnosed colorectal cancer in 2/24 (8.3%) patients, which was missed on index HD-WLE. Endoscopic resection was successful in 23/34 (76.7%) dysplastic lesions identified on DCE. However, DCE was unable to facilitate lesion resection in three patients due to advanced lesion characteristics. Follow-up data was available for 17/24 (70.8%) patients (mean 0.88±0.58 years). Of these patients, 7/17 (41.2%) developed subsequent dysplasia, including 4/17 (23.5%) at a site of prior invisible dysplasia, 2/17 (11.8%) at sites of prior visible dysplasia, and 1/17 (5.88%) at a different site. One of these patients developed high-grade dysplasia requiring resection. Conclusions In this study, DCE is a valuable tool for dysplasia detection and treatment in persons with colonic IBD who have ill-defined dysplasia identified during HD-WLE. Given some patients developed dysplasia following DCE in our cohort, it is important to maintain close follow-up and obtain biopsies around sites of prior invisible and visible dysplasia. Further studies are required to validate our findings. Funding Agencies None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».