Accepted Manuscript White-Light or NBI Colonoscopy in Surveillance of Ulcerative Colitis: A Prospective Multicenter Study L. Leifeld, G. Rogler, A. Stallmach, C. Schmidt, I. Zuber-Jerger, F. Hartmann, M. Plauth, A. Drabik, F. Hofstädter, H.P. Dienes, W. Kruis
PII: DOI: Reference:
S1542-3565(15)00631-X 10.1016/j.cgh.2015.04.172 YJCGH 54270
To appear in: Clinical Gastroenterology and Hepatology Accepted Date: 21 April 2015 Please cite this article as: Leifeld L, Rogler G, Stallmach A, Schmidt C, Zuber-Jerger I, Hartmann F, Plauth M, Drabik A, Hofstädter F, Dienes H, Kruis W, Detect Dysplasia study group, White-Light or NBI Colonoscopy in Surveillance of Ulcerative Colitis: A Prospective Multicenter Study, Clinical Gastroenterology and Hepatology (2015), doi: 10.1016/j.cgh.2015.04.172. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. All studies published in Clinical Gastroenterology and Hepatology are embargoed until 3PM ET of the day they are published as corrected proofs on-line. Studies cannot be publicized as accepted manuscripts or uncorrected proofs.
ACCEPTED MANUSCRIPT White-Light or NBI Colonoscopy in Surveillance of Ulcerative Colitis: A Prospective Multicenter Study
Leifeld L.
(1)
, Rogler G.
(2)
, Stallmach A. (3), Schmidt C. (3), Zuber-Jerger I. (4), Hartmann F.
(5)
,
RI PT
Plauth M. (6), Drabik A. (7), Hofstädter F. (8), Dienes HP (9), Kruis W (1) and the Detect Dysplasia study group.
SC
1 Department of Internal Medicine, Evangelisches Krankenhaus Kalk, Cologne, Germany
M AN U
2 Division of Gastroenterology and Hepatology, Zurich University Hospital, Switzerland 3 Department of Internal Medicine IV, Jena University Hospital, Germany 4 Hospital for Internal Medicine I, Regensburg University Medical Center, Germany. St Marien-Krankenhaus, Frankfurt, Germany.
6
Department of Internal Medicine, Städtisches Klinikum Dessau, Germany.
7
Software Forga, Höhndorf, Germany
8
Institute of Pathology, University of Regensburg, Germany.
9
Institute of Pathology, Cologne University Hospital, Germany
AC C
EP
TE D
5
Detect Dysplasia study group: Büttner R (9), Löser H (9), Drebber U (9), Dignass A (Agaplesion Frankfurter Diakonie Kliniken, Germany), Terjung B (St Josef Hospital, Bonn, Germany), Sauerbruch T (Department of Internal Medicine, University of Bonn, Germany), Schreiber S (Department of Internal Medicine I, Schleswig-Holstein University Hospital, Kiel, Germany), Lanyi B
(1)
, Pfuetzer R
(1)
, Morgenstern J
(1)
, Böhm S (Department of Medicine, University
Hospital, Bruderholz, Switzerland), Böcker U (Vivantes Klinikum Berlin, Germany), Rupf A (Department of Internal Medicine, Klinikum Friedrichshafen, Germany), Appenroth B (Department of Medicine II, Saarland University Medical Center, Homburg, Germany), 1
ACCEPTED MANUSCRIPT Biecker E (Department of Gastroenterology and Hepatology, HELIOS Klinikum Siegburg, Germany), Walldorf N (Universitätsklinikum Halle, Germany).
RI PT
Correspondence: Prof. Dr. med. Ludger Leifeld St Bernward Krankenhaus Hildesheim
SC
Treibestrasse 9
E-mail: [email protected]
M AN U
31134 Hildesheim
Abbreviations: white light: WL, narrow-band imaging: NBI, intraepithelial neoplasia: IN Key words: inflammatory bowel disease, ulcerative colitis, colonoscopy, cancer, dysplasia,
TE D
narrow-band imaging
Contribution:
LL, WK, GR
acquisition of data
LL, WK, AS, CS, IZ, FH, MP, FH, HD
AC C
EP
study concept and design
analysis and interpretation of data LL, WK drafting of the manuscript
LL
statistical analysis
AD
obtained funding
LL, WK
There are no conflicts of interest
2
ACCEPTED MANUSCRIPT Abstract Background and Aims: Early detection of neoplastic lesions is essential in patients with long-standing ulcerative colitis but the best technique of colonoscopy is still controversial.
RI PT
Methods:
We performed a prospective multicenter study in patients with long-standing ulcerative colitis. Two colonoscopies were performed in each patient within 3 weeks to 3 months. In
SC
white-light (WL) colonoscopy stepwise random biopsies (4 biopsies every 10cm), segmental random biopsies (2 biopsies in 5 segments) and targeted biopsies were taken. In NBI
colonoscopy was randomized. Results:
M AN U
colonoscopy segmental and targeted biopsies were taken. The sequence of WL and NBI
In 36 of 159 patients enrolled (22.6%) 54 lesions with intraepithelial neoplasia (IN) were found (51 low-grade, 3 high-grade). In WL colonoscopy we found 11 IN in stepwise, 4 in
TE D
segmental and 15 in targeted biopsies. In NBI colonoscopy 7 IN were detected in segmental and 24 IN in targeted biopsies. Almost all IN were found in one technique alone (Kappa value of WL versus NBI: -0.86, p
PII: DOI: Reference:
S1542-3565(15)00631-X 10.1016/j.cgh.2015.04.172 YJCGH 54270
To appear in: Clinical Gastroenterology and Hepatology Accepted Date: 21 April 2015 Please cite this article as: Leifeld L, Rogler G, Stallmach A, Schmidt C, Zuber-Jerger I, Hartmann F, Plauth M, Drabik A, Hofstädter F, Dienes H, Kruis W, Detect Dysplasia study group, White-Light or NBI Colonoscopy in Surveillance of Ulcerative Colitis: A Prospective Multicenter Study, Clinical Gastroenterology and Hepatology (2015), doi: 10.1016/j.cgh.2015.04.172. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. All studies published in Clinical Gastroenterology and Hepatology are embargoed until 3PM ET of the day they are published as corrected proofs on-line. Studies cannot be publicized as accepted manuscripts or uncorrected proofs.
ACCEPTED MANUSCRIPT White-Light or NBI Colonoscopy in Surveillance of Ulcerative Colitis: A Prospective Multicenter Study
Leifeld L.
(1)
, Rogler G.
(2)
, Stallmach A. (3), Schmidt C. (3), Zuber-Jerger I. (4), Hartmann F.
(5)
,
RI PT
Plauth M. (6), Drabik A. (7), Hofstädter F. (8), Dienes HP (9), Kruis W (1) and the Detect Dysplasia study group.
SC
1 Department of Internal Medicine, Evangelisches Krankenhaus Kalk, Cologne, Germany
M AN U
2 Division of Gastroenterology and Hepatology, Zurich University Hospital, Switzerland 3 Department of Internal Medicine IV, Jena University Hospital, Germany 4 Hospital for Internal Medicine I, Regensburg University Medical Center, Germany. St Marien-Krankenhaus, Frankfurt, Germany.
6
Department of Internal Medicine, Städtisches Klinikum Dessau, Germany.
7
Software Forga, Höhndorf, Germany
8
Institute of Pathology, University of Regensburg, Germany.
9
Institute of Pathology, Cologne University Hospital, Germany
AC C
EP
TE D
5
Detect Dysplasia study group: Büttner R (9), Löser H (9), Drebber U (9), Dignass A (Agaplesion Frankfurter Diakonie Kliniken, Germany), Terjung B (St Josef Hospital, Bonn, Germany), Sauerbruch T (Department of Internal Medicine, University of Bonn, Germany), Schreiber S (Department of Internal Medicine I, Schleswig-Holstein University Hospital, Kiel, Germany), Lanyi B
(1)
, Pfuetzer R
(1)
, Morgenstern J
(1)
, Böhm S (Department of Medicine, University
Hospital, Bruderholz, Switzerland), Böcker U (Vivantes Klinikum Berlin, Germany), Rupf A (Department of Internal Medicine, Klinikum Friedrichshafen, Germany), Appenroth B (Department of Medicine II, Saarland University Medical Center, Homburg, Germany), 1
ACCEPTED MANUSCRIPT Biecker E (Department of Gastroenterology and Hepatology, HELIOS Klinikum Siegburg, Germany), Walldorf N (Universitätsklinikum Halle, Germany).
RI PT
Correspondence: Prof. Dr. med. Ludger Leifeld St Bernward Krankenhaus Hildesheim
SC
Treibestrasse 9
E-mail: [email protected]
M AN U
31134 Hildesheim
Abbreviations: white light: WL, narrow-band imaging: NBI, intraepithelial neoplasia: IN Key words: inflammatory bowel disease, ulcerative colitis, colonoscopy, cancer, dysplasia,
TE D
narrow-band imaging
Contribution:
LL, WK, GR
acquisition of data
LL, WK, AS, CS, IZ, FH, MP, FH, HD
AC C
EP
study concept and design
analysis and interpretation of data LL, WK drafting of the manuscript
LL
statistical analysis
AD
obtained funding
LL, WK
There are no conflicts of interest
2
ACCEPTED MANUSCRIPT Abstract Background and Aims: Early detection of neoplastic lesions is essential in patients with long-standing ulcerative colitis but the best technique of colonoscopy is still controversial.
RI PT
Methods:
We performed a prospective multicenter study in patients with long-standing ulcerative colitis. Two colonoscopies were performed in each patient within 3 weeks to 3 months. In
SC
white-light (WL) colonoscopy stepwise random biopsies (4 biopsies every 10cm), segmental random biopsies (2 biopsies in 5 segments) and targeted biopsies were taken. In NBI
colonoscopy was randomized. Results:
M AN U
colonoscopy segmental and targeted biopsies were taken. The sequence of WL and NBI
In 36 of 159 patients enrolled (22.6%) 54 lesions with intraepithelial neoplasia (IN) were found (51 low-grade, 3 high-grade). In WL colonoscopy we found 11 IN in stepwise, 4 in
TE D
segmental and 15 in targeted biopsies. In NBI colonoscopy 7 IN were detected in segmental and 24 IN in targeted biopsies. Almost all IN were found in one technique alone (Kappa value of WL versus NBI: -0.86, p
