Dysplasie des MICI: physiopathologie et point de vue du pathologiste

Abstract

Colorectal cancer is the most lethal long-term complication of chronic inflammatory bowel disease (IBD). It results from a complex sequence of molecular alterations leading to a neoplastic progression from chronic inflammation to dysplasia and then cancer. Dysplasia is the earliest morphologic manifestation of high risk of cancer in IBD. The major goal in the long-term management of patients is the endoscopic detection of dysplasia for histological diagnosis, classification and grading according to a precise nomenclature. Clinical recommendations are based on the histologic criteria and nomenclature used by pathologists in order to reduce cancer-related mortality in this population. Joint efforts between endoscopists and pathologists are essential to improving the diagnosis of dysplasia, taking into account patient background and anamnesis. We hope that prospective studies on molecular pathways between chronic inflammation and neoplasia will bring earlier molecular markers for cancer detection.