STUDY OF PATTERNS OF DYSPLASIA IN INFLAMMATORY BOWEL DISEASES

Abstract

Background: Inflammatory bowel disease (IBD) comprises of Ulcerative colitis, Crohn’s disease and colitis of indeterminate type. Patients with long established IBD are at a greater risk for development of colorectal carcinoma (CRC). The best marker for cancer risk in IBD is dysplasia. IBD on biopsy can show low grade dysplasia (LGD) or high grade dysplasia (HGD) or histological features indefinite for dysplasia. Aims: 1) Determination of the incidence of LGD, HGD and CRC in IBD patients. 2) Evaluation of presence of any correlation between duration of IBD and extent of intestinal involvement by IBD and between duration of IBD and multifocality of dysplasia. Materials and Method: 393 patients with clinical suspicion of IBD were enrolled in this study. During surveillance endoscopy number of biopsy samples taken from each case were 10-15. Histopathological examination of these biopsy samples was done. Results: Out of 266 patients of IBD who turned up for surveillance endoscopy, the incidences of LGD, HGD, CRC and IBD indeterminate for dysplasia were found to be 10.90%, 4.51%, 4.51% and 2.63% respectively. On statistical analysis it was discovered that in both UC and CD the extent of intestinal involvement was directly proportional to the duration of the disease. In both UC and CD, longer disease durations were linked to more foci of dysplasia. Conclusion: In both UC and CD, longer disease durations is linked to the extent of intestinal involvement and number of foci of dysplasia while type of dysplasia (LGD/HGD) is not related to duration of IBD. In IBD with UC incidence of PSC is linked with the extent of intestinal involvement.