P571 Frequency and risk factors of advanced neoplasia in Korean IBD patients with Low Grade Dysplasia in previous surveillance
Park, Y.E.(1)*;Kim, D.H.(2);Park, S.K.(3);Lee, Y.J.(4);Lee, C.K.(5);Kim, E.S.(6);Kim, K.O.(7);
(1)Inje University School of Medicine- Haeundae Paik Hospital, Division of Gastroenterology- Department of Internal Medicine, Busan, Korea- Republic Of;(2)Chonnam National University Hospital- Chonnam National University Medical School, Division of Gastroenterology- Department of Internal Medicine, Gwangju, Korea- Republic Of;(3)Kangbuk Samsung Hospital- Sungkyunkwan University School of Medicine, Division of Gastroenterology- Department of Internal Medicine and Gastrointestinal Cancer Center, Seoul, Korea- Republic Of;(4)Dongsan Medical Center- Keimyung University School of Medicine, Division of Gastroenterology and Hepatology- Department of Internal Medicine, Daegu, Korea- Republic Of;(5)Kyung Hee University-, Department of Internal Medicine- School of Medicine, Seoul, Korea- Republic Of;(6)Kyungpook National University, Division of Gastroenterology- Department of Internal Medicine- School of Medicine, Daegu, Korea- Republic Of;(7)Yeungnam University College of Medicine, Division of Gastroenterology and Hepatology- Department of Internal Medicine, Daegu, Korea- Republic Of;
There are insufficient studies on clinical outcome after surveillance of low grade dysplasia (LGD) in patients with inflammatory bowel disease (IBD). We aimed to evaluate the clinical feature, frequency and risk factors of advanced neoplasia in IBD patients after diagnosis of LGD
From 2003 to 2020, medical records of 166 IBD patients from 6 university hospitals in Korea were reviewed retrospectively. All of the patients were diagnosed as LGD in surveillance. Patents’ baseline characteristics, disease status, polyp characteristics and treatment were evaluated. The frequency and risk factors of advanced neoplasia were also analyzed.
Disease duration was 11.47 years (7.85-14.50), and follow-up duration was 3.74 years (1.95-7.58). Colitis associated LGD was noted in 56 cases (33.7%), Advanced neoplasia developed in 12 cases (6 large LGD, 3 tubulovillous adenoma, 3 high grade dysplasia) and all the cases developed from UC. Patients with advanced neoplasia had significantly higher Mayo score and colitis-related dysplasia were more common than sporadic lesions (83.3% vs. 29.9%; P<0.001). In multivariate analysis, colitis-associated LGD significantly increased the risk of developing advanced neoplasia (Odds ratio [OR], 10.516; 95% confidence interval [CI], 2.064-53.577; P=0.005). Among patients with colitis-associated lesions, a significant risk factor for advanced neoplasia was a history of LGD (OR, 9.429; 95% CI, 1.330-66.863; P=0.025).
Advanced neoplasia developed in 7.2% of IBD patients with LGD. Because most of advanced neoplasia developed from colitis-associated lesions, more careful examination is suggested in patients with colitis -associated LGD, especially with previous history, in surveillance colonoscopy.