Kidambi TD, Schmajuk G, Gross AJ, Ostroff JW, Terdiman JP, Lee JK. Endoscopy is of low yield in the identification of gastrointestinal neoplasia in patients with dermatomyositis: A cross-sectional study. World J Gastroenterol 2017; 23(26): 4788-4795 [PMID: 28765700 DOI: 10.3748/wjg.v23.i26.4788]
Corresponding Author of This Article
Jeffrey K Lee, MD, MAS, Division of Gastroenterology, University of California, 1701 Divisadero, San Francisco, CA 94115, United States. jeff.lee@ucsf.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
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/
World J Gastroenterol. Jul 14, 2017; 23(26): 4788-4795 Published online Jul 14, 2017. doi: 10.3748/wjg.v23.i26.4788
Table 1 Baseline demographic and indications for endoscopy n (%)
Baseline characteristics
Had endoscopy (n = 79)
Age (mean ± SD)
56.7 (14.4)
Male gender
21 (27)
Age at dermatomyositis diagnosis (mean ± SD)
50.1 (15.9)
Disease duration (mean ± SD) at time of endoscopy
6.8 (6.6)
Personal history of cancer
8 (10.1)
Melanoma
1
Prostate
1
Endometrial
1
NCC
1
HCC
1
RCC
1
AdenoCA of unknown origin
2
Indication for EGD
Had EGD (n = 47)
Screening
19 (40.4)
Dysphagia
13 (27.7)
Dyspepsia/pain
9 (19.1)
IDA
2 (4.3)
Weight loss
3 (6.4)
Abnormal CT scan
1 (2.1)
Indication for colonoscopy
Had colonoscopy (n = 67)
Screening
49 (73.1)
Surveillance
2 (3.0)
Diarrhea, abdominal pain
11 (16.4)
IDA
2 (3.0)
Weight loss
1 (1.5)
Blood in stool
1 (1.5)
Abnormal CT
1 (1.5)
Table 2 Yield of endoscopy n (%)
Findings on EGD, n = 47
Malignancy
0 (0)
Pre-malignancy
3 (6.4)
Barrett's esophagus without dysplasia
2
Gastric intestinal metaplasia
1
Non-malignant findings
8 (17)
Esophageal varices
2
H. pylori gastritis
4
CMV esophagitis
1
Candida esophagitis
1
Normal
36 (76.6)
Findings on colonoscopy, n = 67
Colorectal cancer
0 (0)
Any adenoma
10 (14.9)
Inflammatory bowel disease
4 (6.0)
Normal
53 (79.1)
Table 3 Yield of endoscopy stratified by age n (%)
Age < 50 (n = 21)
Age ≥ 50 (n = 26)
Age ≥ 50 (n = 46)
P value
Findings on EGD
Normal
16 (76.2)
20 (76.9)
-
0.95
Pre-malignancy
1 (4.8)
2 (7.7)
-
1.00
Malignancy
0 (0)
0 (0)
-
1.00
Non-malignant
4 (19.0)
4 (15.4)
-
1.00
Findings on Colonoscopy
Normal
17 (81.0)
-
36 (78.3)
0.80
Any adenoma
1 (4.8)
-
9 (20.0)
0.15
Colorectal cancer
0 (0)
-
0 (0)
1.00
Inflammatory bowel disease
2 (9.5)
-
2 (4.3)
0.58
Table 4 Yield of endoscopy by presence of symptoms n (%)
Asymptomatic
Symptomatic
P value
n = 19
n = 51
n = 28
n = 16
Findings on EGD
Normal
15 (78.9)
-
21 (75.0)
-
0.75
Pre-malignancy
0 (0)
-
3 (10.7)
-
0.26
Barrett's without dysplasia
-
-
2 (7.1)
-
-
Gastric intestinal metaplasia without dysplasia
-
-
1 (3.6)
-
-
Malignancy
0 (0)
-
0 (0)
-
-
Non-malignant
4 (21.1)
-
4 (14.3)
-
0.70
Varices
2 (10.5)
-
-
-
-
Helicobacter pylori gastritis
2 (10.5)
-
2 (7.1)
-
-
Cytomegalovirus esophagitis
-
-
1 (3.6)
-
-
Candida esophagitis
-
-
1 (3.6)
-
-
Findings on Colonoscopy
Normal
-
44 (86.3)
-
9 (56.3)
0.01
Pre-malignancy
-
7 (13.7)
-
3 (18.8)
0.69
Advanced adenoma
-
1 (2.0)
-
1 (6.3)
-
Low risk tubular adenoma
-
5 (9.8)
-
1 (6.3)
-
≥ 3 tubular adenomas
-
1 (2.0)
-
1 (6.3)
-
Malignancy
-
0 (0)
-
0 (0)
-
Non-malignant findings
-
0 (0)
-
4 (25)
< 0.01
IBD
-
-
-
3 (18.8)
-
Microscopic colitis
-
-
-
1 (6.3)
-
Citation: Kidambi TD, Schmajuk G, Gross AJ, Ostroff JW, Terdiman JP, Lee JK. Endoscopy is of low yield in the identification of gastrointestinal neoplasia in patients with dermatomyositis: A cross-sectional study. World J Gastroenterol 2017; 23(26): 4788-4795