教員業績データベース |
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論文種別 | 原著 |
言語種別 | 英語 |
査読の有無 | 査読なし |
表題 | Comparison of Targeted vs Random Biopsies for Surveillance of Ulcerative Colitis-Associated Colorectal Cancer. |
掲載誌名 | 正式名:Gastroenterology 略 称:Gastroenterology ISSNコード:1528-0012(Electronic)0016-5085(Linking) |
掲載区分 | 国外 |
巻・号・頁 | 151(6),pp.1122-30 |
著者・共著者 | Watanabe Toshiaki, Ajioka Yoichi, Mitsuyama Keiichi, Watanabe Kenji, Hanai Hiroyuki, Nakase Hiroshi, Kunisaki Reiko, Matsuda Keiji, Iwakiri Ryuichi, Hida Nobuyuki, Tanaka Shinji, Takeuchi Yoshiaki, Ohtsuka Kazuo, Murakami Kazunari, Kobayashi Kiyonori, Iwao Yasushi, Nagahori Masakazu, Iizuka Bunei, Hata Keisuke, Igarashi Masahiro, Hirata Ichiro, Kudo Shin-Ei, Matsumoto Takayuki, Ueno Fumiaki, Watanabe Gen, Ikegami Masahiro, Ito Yoko, Oba Koji, Inoue Eisuke, Tomotsugu Naoki, Takebayashi Toru, Sugihara Kenichi, Suzuki Yasuo, Watanabe Mamoru, Hibi Toshifumi |
発行年月 | 2016/12 |
概要 | BACKGROUND & AIMS:A random biopsy is recommended for surveillance of ulcerative colitis (UC)-associated colorectal cancer. However, a targeted biopsy might be more effective. We conducted a randomized controlled trial to compare rates of neoplasia detection by targeted vs random biopsies in patients with UC.METHODS:We performed a study of 246 patients with UCMETHODS:for 7 years or more, seen at 52 institutions in Japan from October 1, 2008 through December 31, 2010. Patients were randomly assigned to the random group (4 random biopsies collected every 10 cm in addition to targeted biopsies, n = 122) or the target group (biopsies collected from locations of suspected neoplasia, n = 124). The primary end point was the number of neoplastic lesions detected in a single surveillance colonoscopy. We estimated the ratio and difference in the mean number of neoplastic lesions between the groups. We also evaluated the non-inferiority between the groups as an exploratory study. A non-inferiority margin of 0.65 (0.13 of 0.20) was considered for the ratio of the mean number of neoplastic lesions between groups.RESULTS:The mean number of biopsies found to contain neoplastic tissue per colonoscopy was 0.211 (24 of 114) in the target group and 0.168 (18 of 107) in the random group (ratio of 1.251; 95% confidence interval, 0.679-2.306). The lower limit was above the non-inferiority margin of 0.65. Neoplasias were detected in 11.4% of patients in the target group and 9.3% of patients in the random group (P = .617). Larger numbers of biopsy samples per colonoscopy were collected in the random group (34.8 vs 3.1 in the target group; PRESULTS:<RESULTS:.001), and the total examination time was longer (41.7 vs 26.6 minutes in the target group; P RESULTS:<RESULTS: .001). In the random group, all neoplastic tissues found in random biopsies were collected from areas of the mucosa with a history or presence of inflammation.CONCLUSIONS:In a randomized controlled trial, we found that targeted |
DOI | 10.1053/j.gastro.2016.08.002 |
PMID | 27523980 |