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P266 Risk factors for colorectal neoplasia in ulcerative colitis

Saoula H.*1, Boutaleb A.2, Aissaoui M.2, Salah A.2, Belhocine K.3, Gamar L.3, Hamidouche D.2, Mahiou H.2, Aissat Y.2, Mitiche A.2, Zmiri Y.2, Osmane R.2, Bounab N.3, Kecili L.3, Berkane S.3, Boucekkine T.3, Amir Z.c.4, Nakmouche M.2

1CHU of Bab El Oued, Epidemiology, Algiers, Algeria 2CHU of Bab El Oued, Gastroenterology, Algiers, Algeria 3CHU Mustapha, Gastroenterology, Algiers, Algeria 4CHU Mustapha, Pathology, Algiers, Algeria

Background

There is a higher risk of neoplasia in ulcerative colitis than in general population; the aim of this study was to identify risk factors for dysplasia and colorectal cancer in Algerian patients with ulcerative colitis.

Methods

in this prospective study, patients with longstanding ulcerative colitis in clinical remission, had an endoscopic surveillance between January 2009 and january2015, then patients with neoplasic lesions were compared to patients without colorectal neoplasia, to identify risk factors for neoplasia in ulcerative colitis.

Results

106 patients were enrolled in a surveillance program by chromoendoscopy. We diagnosed 49 neoplastic lesions in 31 patients; 6patients with adenocarcinomas, and 27 patients with dysplasia. These patients were compared to the 75 patients without neoplasic lesions.

In univariate analysis, risk factors for colorectal cancer were: longstanding colitis, time between first symptoms and the diagnostic of colitis longer than 6 months, spondylarthritis, colonic stricture, tubular colon, and inflammatory polyps.

Risk factors for dysplasia were: high age at inclusion in the study, and time between first symptoms and the diagnostic of colitis longer than 6 months; after exclusion of the sporadic adenomas (adenomas outside colitic mucosa) risk factors for dysplasia were: longstanding colitis, time between first symptoms and the diagnostic of colitis longer than 6 months, inflammatory polyps, pancolitis, and corticodependency.

After multivariate analysis, Risk factors for CCR or high grade neoplasia were longstanding colitis, time between first symptoms and the diagnostic of colitis longer than 6 months and inflammatory polyps. Risk factors for dysplasia were long standing disease and corticodependancy.

Regular maintenance treatment was a protector factor of colorectal cancer.

Conclusion

in our study, risk factors for CCR or high grade neoplasia are longstanding colitis, time between first symptoms and the diagnostic of colitis longer than 6 months and inflammatory polyps. Risk factors for dysplasia are long standing disease and corticodependancy. Regular maintenance treatment is a protective factor.