Colorectal polyps in ulcerative colitis and Crohn's colitis.
Bibliographic record
Abstract
AIM: Patients with long-standing inflammatory bowel disease (IBD) have higher risk for developing dysplasia and colorectal cancer and consequently surveillance colonoscopy is required. The colonic lesion in these patients are often flat and subtle and may be difficult to detect by white light standard endoscopy. We aimed to review the potential of novel electronic optical enhancement techniques to enhance endoscopic diagnosis and therapeutic management of dysplasia in IBD and emerging strategies that may be useful. METHODS: We identified eligible and appropriate articles by electronic search of PubMed, MEDLINE and EMBASE between January 1980 and June 2015 using key words: dysplasia, colorectal cancer and IBD, surveillance in IBD, novel endoscopic techniques in IBD, therapeutic endoscopy in IBD, endoscopic mucosal resection, endoscopic submucosal dissection, pseudopolyps, dysplasia associated lesion or mass, adenoma associated lesion or mass, chromoendoscopy, autofluorescence, virtual chromoendoscopy, confocal endomicroscopy. RESULTS: Segmental random biopsies during white-light colonoscopy have been the recommended strategy for many years. Chromoendoscopy with colonic dye spray has been gradually implemented in recent years in order to highlight abnormalities in the mucosa and target biopsies. Simultaneously, a new generation of high-definition endoscopes with electronic filter technology that provide a detailed assessment of the mucosal and vascular colonic pattern havebeen developed and these have been adopted in clinical practise. Furthermore, the introduction of confocal laser endomicroscopy (CLE) offers the possibility to assess and characterize lesions in real-time histology and it can predict dysplastic changes with high accuracy. With the evolving novel techniques and fresh evidence, modification of the current surveillance guidelines were required. Therefore, the SCENIC consensus guidelines have been recently published and have defined the best endoscopic techniques to detect and characterize dysplasia and the clinical implications and management of dysplasia in IBD patients. CONCLUSION: Many uncertainties still remain whetherdye chromoendoscopy with targeted biopsies will be established as standard practice. However, optical enhancement endoscopic techniques are promising to perform surveillance colonoscopy with targeted biopsies for better assessment and management of the dysplastic lesions in IBD. Further studies are required to determine the best strategy for the diagnosis and treatment of dysplasia in IBD patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".