Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2015; 21(9): 2693-2699
Published online Mar 7, 2015. doi: 10.3748/wjg.v21.i9.2693
Clinical usefulness of endoscopic ultrasonography for the evaluation of ulcerative colitis-associated tumors
Kiyonori Kobayashi, Kana Kawagishi, Shouhei Ooka, Kaoru Yokoyama, Miwa Sada, Wasaburo Koizumi
Kiyonori Kobayashi, Research and Development Center for New Medical Frontiers, Kitasato University, School of Medicine, Sagamihara, Kanagawa 252-0380, Japan
Kana Kawagishi, Shouhei Ooka, Kaoru Yokoyama, Miwa Sada, Wasaburo Koizumi, Department of Gastroenterology, Kitasato University, School of Medicine, Sagamihara 252-0380, Japan
Author contributions: Kobayashi K wrote the article and made the figure and table; Kobayashi K, Kawagishi K and Ooka S performed data collection; Yokoyama K, Sada M and Koizumi W provided important input concerning the study design; and Koizumi W recommended the most appropriate medical journal for submission of this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kiyonori Kobayashi, MD, PhD, Associate Professor, Research and Development Center for New Medical Frontiers, Kitasato University, School of Medicine, 2-1-1 Asamizodai, Minami-ku, Sagamihara, Kanagawa 252-0380, Japan. koba-eus@kitasato-u.ac.jp
Telephone: +81-42-7489111 Fax: +81-42-7498690
Received: August 5, 2014
Peer-review started: August 6, 2014
First decision: August 27, 2014
Revised: September 22, 2014
Accepted: November 18, 2014
Article in press: November 19, 2014
Published online: March 7, 2015
Processing time: 215 Days and 19.4 Hours
Abstract

AIM: To evaluate the clinical usefulness of endoscopic ultrasonography (EUS) for the diagnosis of the invasion depth of ulcerative colitis-associated tumors.

METHODS: The study group comprised 13 patients with 16 ulcerative colitis (UC)-associated tumors for which the depth of invasion was preoperatively estimated by EUS. The lesions were then resected endoscopically or by surgical colectomy and were examined histopathologically. The mean age of the subjects was 48.2 ± 17.1 years, and the mean duration of UC was 15.8 ± 8.3 years. Two lesions were treated by endoscopic resection and the other 14 lesions by surgical colectomy. The depth of invasion of UC-associated tumors was estimated by EUS using an ultrasonic probe and was evaluated on the basis of the deepest layer with narrowing or rupture of the colonic wall.

RESULTS: The diagnosis of UC-associated tumors by EUS was carcinoma for 13 lesions and dysplasia for 3 lesions. The invasion depth of the carcinomas was intramucosal for 8 lesions, submucosal for 2, the muscularis propria for 2, and subserosal for 1. Eleven (69%) of the 16 lesions arose in the rectum. The macroscopic appearance was the laterally spreading tumor-non-granular type for 4 lesions, sessile type for 4, laterally spreading tumor-granular type for 3, semi-pedunculated type (Isp) for 2, type 1 for 2, and type 3 for 1. The depth of invasion was correctly estimated by EUS for 15 lesions (94%) but was misdiagnosed as intramucosal for 1 carcinoma with high-grade submucosal invasion. The 2 lesions treated by endoscopic resection were intramucosal carcinoma and dysplasia, and both were diagnosed as intramucosal lesions by EUS.

CONCLUSION: EUS provides a good estimation of the invasion depth of UC-associated tumors and may thus facilitate the selection of treatment.

Keywords: Ulcerative colitis; Colitis-associated tumor; Diagnosis of invasion depth; Selection of treatment; Endoscopic ultrasonography

Core tip: The results of large studies evaluating endoscopic ultrasonography (EUS) for the diagnosis of ulcerative colitis (UC)-associated tumors have not been reported previously. The aim of this study was to evaluate the usefulness of EUS for UC-associated tumors. The study group comprised 16 UC-associated tumors for which the depth of invasion was preoperatively estimated by EUS. The depth of invasion was correctly estimated by EUS for 15 lesions (94%). The 2 mucosal lesions treated by endoscopic resection were both diagnosed correctly. EUS provides a good estimation of the invasion depth of UC-associated tumors and may thus facilitate the selection of treatment.