Risk Of Neoplasia In Ulcerative Colitis Research Articles

Fecal microbiota and bile acids in IBD patients undergoing screening for colorectal cancer

ABSTRACT Due to the potential role of the gut microbiota and bile acids in the pathogenesis of both inflammatory bowel disease (IBD) and sporadic colorectal cancer, we aimed to determine whether these factors were associated with colorectal cancer in IBD patients. 215 IBD patients and 51 non-IBD control subjects were enrolled from 10 French IBD centers between September 2011 and July 2018. Fecal samples were processed for bacterial 16S rRNA gene sequencing and bile acid profiling. Demographic, clinical, endoscopic, and histological outcomes were recorded. Characteristics of IBD patients included: median age: 41.6 (IQR 22); disease duration 13.2 (13.1); 47% female; 21.9% primary sclerosing cholangitis; 109 patients with Crohn’s disease (CD); 106 patients with ulcerative colitis (UC). The prevalence of cancer was 2.8% (6/215: 1 CD; 5 UC), high-grade dysplasia 3.7% (8/215) and low-grade dysplasia 7.9% (17/215). Lachnospira was decreased in IBD patients with cancer, while Agathobacter was decreased and Escherichia-Shigella increased in UC patients with any neoplasia. Bile acids were not associated with cancer or neoplasia. Unsupervised clustering identified three gut microbiota clusters in IBD patients associated with bile acid composition and clinical features, including a higher risk of neoplasia in UC in two clusters when compared to the third (relative risk (RR) 4.07 (95% CI 1.6–10.3, P < .01) and 3.56 (95% CI 1.4–9.2, P < .01)). In this multicentre observational study, a limited number of taxa were associated with neoplasia and exploratory microbiota clusters co-associated with clinical features, including neoplasia risk in UC. Given the very small number of cancers, the robustness of these findings will require assessment and validation in future studies.

Cumulative burden of inflammation predicts colorectal neoplasia risk in ulcerative colitis: a large single-centre study

ObjectiveUlcerative colitis (UC) is a dynamic disease with its severity continuously changing over time. We hypothesised that the risk of colorectal neoplasia (CRN) in UC closely follows an actuarial accumulative...

Increased Expression of DNA Methyltransferase-1 in Non-Neoplastic Epithelium Helps Predict Colorectal Neoplasia Risk in Ulcerative Colitis

Aims: To clarify the possible significance of increased expression of DNA methyltransferase (DNMT)-1 in the tumorigenesis of colorectal neoplasia in ulcerative colitis (UC) and to clarify whether analysis of DNMT1 expression in non-neoplastic epithelium can contribute to the prediction of increased risk for UC-associated neoplasia. Methods: Sixty-two patients with long-standing and extensive UC were included in this study: 31 with colorectal neoplasia (dysplasia in 11 and invasive cancer in 20) and 31 without. Immunohistochemical analysis and quantitative RT-PCR were performed to determine the expression of DNMT1 in rectal epithelium of UC patients without neoplasia, and in non-neoplastic rectal epithelium and colorectal neoplasia of UC patients with neoplasia. Results: The immunoreactive DNMT1 expression gradually increased from rectal epithelium of UC patients without neoplasia (0.13 ± 0.07) to non-neoplastic rectal epithelium of UC patients with neoplasia (0.32 ± 0.12, p < 0.001), and to colorectal neoplasia (0.54 ± 0.20, p < 0.001). Among 31 neoplasias, there was no difference in the immunoreactive DNMT1 expressions between dysplasia and invasive cancer (0.47 ± 0.52 vs. 0.58 ± 0.63). The expression level of DNMT1 mRNA tended to increase gradually from rectal epithelium of UC patients without neoplasia (0.53 ± 0.34) to non-neoplastic rectal epithelium of UC patients with neoplasia (0.88 ± 0.57, p = 0.06), and to colorectal neoplasia (1.38 ± 0.64, p = 0.07). Conclusion: Increased expression of DNMT1 in non-neoplastic epithelium may precede or be a relatively early event in UC-associated tumorigenesis, and may help predict the risk of colorectal neoplasia in UC.

Methylation of estrogen receptor gene in nonneoplastic epithelium as a marker of colorectal neoplasia risk in ulcerative colitis

Methylation of estrogen receptor gene in nonneoplastic epithelium as a marker of colorectal neoplasia risk in ulcerative colitis