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Lang 1 , G. Leventhal 2 , T. DeWouters 3 , M. Scharl 1 , M. It is clear that colonoscopic surveillance in the present form is neither ideal nor practical. We should reconsider the guidelines about the colonoscopy surveillance based on the other new reliable date and method. The ideal frequency of surveillance is not clear.
Further studies are necessary to optimize the frequency of surveillance, including cost-effectiveness, and to make guidelines considering emerging methods and technologies. Despite the proven usefulness of colonoscopy surveillance protocols and increased risk of CRC with UC, we could not determinant a useful in clinical diagnosing such as genetic or serological marker. After analyzing the association of the whole genome, the single nucleotide polymorphism SNP or more and the genetic loci or more were found to be associated with IBD[ 44 ]. There was another genetic instability report[ 45 ] that sought to identify IBD-associated SNPs that are potential markers for CAC by comparing groups of UC patients with and without neoplasia matched for sex, disease duration and age at diagnosis.
Their conclusion was that none of the studied IBD-associated SNPs were strongly associated with UC-neoplasia which may be the result of genetic mutations in molecular pathways other than those that predispose to inflammation. On the other hand, there was a unique report that applied the tree models by considering the response variable as the CAC or UC group and the explanatory variable as the criteria studied by univariate analysis[ 46 ].
We proposed the useful method which analysis is a tree model permits the automatic execution of the process of determining the factors, setting the threshold value and by differentiating the patients successively into two groups during the process automatically.
Therefore, it might be another possibility to help identify the indication and timing for surgery in UC patients, because the ideal surveillance methods have not yet been established.
Colitis-Associated Cancer | Masato Kusunoki | Springer
On the other hand, sporadic adenoma and adenocarcinoma can arise coincidentally in patients with UC. From the perspective of clinical considerations, accurate pathological diagnosis is very important for distinguishing between different pathological entities, given their different therapeutic consequences such as sporadic adenocarcinoma and CAC. Anal function and quality of life differ substantially between total proctocolectomy with ileal pouch anal anastomosis IPAA and low anterior resection LAR.
A key point is that further proctocolectomy and IPAA may be suitable for sporadic cancers in the lower rectum. In patients with UC, irrespective of the degree of colitis, LAR should not be selected for sporadic cancer in the lower rectum except in older patients, based on considerations of quality of life and risk of further colitis. In elderly patients with poor anal function, surgical procedures should obviously be considered based on overall considerations including prognosis of the cancer, degree of inflammation with colitis, and potential requirements for further treatment.
In view of the risk of recurrent colitis and cancer, partial resection might be less advantageous than proctocolectomy.
- Karl Schuhmann, Selected papers on phenomenology;
- Genomic characterization of colitis-associated colorectal cancer.
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Proctocolectomy with IPAA may be safe for advanced CRC regardless of the origin as colitic or sporadic cancer, because of the difficulty of differentiation, ready invasive behavior against an inflamed background and worsened potential for further progressive colitis in younger patients.
Decisions on surgical procedures should be made based on full consideration of background factors including age, degree of colitis and cancer prognosis.
There was an interesting report on the risk of ileoanal pouch neoplasia in patients with IBD[ 48 ]. The purpose of their study was to determine the cumulative incidence of pouch neoplasia in patients with IBD and to identify risk factors for developing pouch neoplasia.
The incidence and prevalence of pouch neoplasia in patients with IBD are probably low. According to the latest review, only 42 pouch adenocarcinomas have been described in the literature[ 49 ]. A previous study reported a cumulative incidence of pouch neoplasia of 1. However, these data were collected in a single tertiary pouch referral center and may not be representative of the general IBD population with IPAA.
Furthermore, the relatively low incidence makes it difficult to assess risk factors for the development of pouch neoplasia. The result of the study indicated that the incidence of pouch neoplasia in patients with IBD without a history of colorectal neoplasia is relatively low. Prior dysplasia or colon cancer is associated with an approximately 4- and fold increase in risk, respectively, of developing pouch neoplasia.
However, according to the recent reports that the rate of CAC is increasing in UC patients, and such cases have a worse prognosis. As such, there is a need for appropriate diagnosis and treatment. Advanced Search. This Article. Academic Rules and Norms of This Article. Citation of this article. Kinugasa T, Akagi Y.
Genomic characterization of colitis-associated colorectal cancer
Status of colitis-associated cancer in ulcerative colitis. Corresponding Author of This Article. Publishing Process of This Article. Research Domain of This Article. Gastroenterology and Hepatology. Article-Type of This Article. Topic Highlight. Open-Access Policy of This Article. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers.
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Mice and CAC protocol
Journal Information of This Article. Published by Baishideng Publishing Group Inc. All rights reserved. World J Gastrointest Oncol. Author contributions : Kinugasa T contributed to concept and design; both authors contributed to this paper.
Cytokine Networks in Animal Models of Colitis-associated Cancer
Conflict-of-interest statement : Authors declare no conflict of interests for this article. Open-Access : This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. Correspondence to : Dr. Key Words: Inflammatory bowel disease , Ulcerative colitis , Colitis-associated cancer , Surgical therapy , Colorectal cancer surveillance.
Citation: Kinugasa T, Akagi Y.