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首页> 外文期刊>Current opinion in gastroenterology >Colonoscopic surveillance in inflammatory bowel disease.
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Colonoscopic surveillance in inflammatory bowel disease.

机译：结肠镜检查在炎症性肠病中的应用。

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PURPOSE OF REVIEW: To describe recent findings in the literature aimed at decreasing systematic error in dysplasia surveillance in inflammatory bowel disease. RECENT FINDINGS: Despite great promise, colonoscopic surveillance in inflammatory bowel disease has yet to be demonstrated to reduce colorectal cancer mortality. In part, this stems from a number of inherent systematic troubles, including low rates of observer agreement among pathologists; lack of consensus on the natural history of dysplasia, particularly low-grade dysplasia; the patchy nature of dysplasia, which leads to sampling error caused by insufficient biopsy by endoscopists; and incomplete patient follow-up. Recent publications that have focused on defining better the natural history of different levels of dysplasia and improving dysplasia identification at the time of colonoscopy may aid in overcoming the flaws of surveillance. The key recent findings include conflicting evidence on the relative danger of flat low-grade dysplasia, the safety of treating polypoid low-grade dysplasia as a benign adenoma in the absence of flat dysplasia in the rest of the colon or the surrounding mucosa, and preliminary support of chromoendoscopy to target dysplasia better during colonoscopy and to limit unnecessary nontargeted biopsies. SUMMARY: These and other advances stand a reasonable chance of making surveillance a more accurate tool to discriminate between patients with chronic colitis likely to progress to advanced pathology and those less likely to do so. Such advances may result in effective surveillance in which both colorectal cancer mortality and unnecessary colectomy may be limited.
机译：审查的目的：描述文献中旨在减少炎症性肠病异型增生监测中系统错误的最新发现。最新发现：尽管前景广阔，但结肠镜检查对炎症性肠病的监测尚未能降低大肠癌的死亡率。在某种程度上，这是由于许多内在的系统性问题引起的，包括病理学家之间观察者同意率较低。对自然发育异常，特别是轻度发育不良的自然历史缺乏共识;不典型增生的斑块性质，导致内镜医师活检不充分导致采样错误;和不完整的患者随访。最近的出版物侧重于更好地定义不同水平的异型增生的自然病史，并在结肠镜检查时改善异型增生的识别，可能有助于克服监测的缺陷。最近的主要发现包括关于扁平低度不典型增生的相对危险性的相互矛盾的证据，在结肠的其余部分或周围粘膜不存在扁平不典型增生的情况下将息肉样低度不典型增生作为良性腺瘤治疗的安全性支持肠胃镜检查以更好地靶向不典型增生，并限制不必要的非靶向活检。简介：这些和其他进展有合理的机会使监视成为一种更准确的工具，以区分可能发展为晚期病理的慢性结肠炎患者和不太可能发展为晚期病理的患者。这样的进展可能导致有效的监测，其中结肠直肠癌的死亡率和不必要的结肠切除术都可能受到限制。

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