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. 1991 Aug;32(8):900–904. doi: 10.1136/gut.32.8.900

Carcinoma and DNA aneuploidy in Crohn's colitis--a histological and flow cytometric study.

R Löfberg 1, O Broström 1, P Karlén 1, A Ost 1, B Tribukait 1
PMCID: PMC1378959  PMID: 1885072

Abstract

Twenty four patients with longstanding colonic Crohn's disease were examined prospectively with colonoscopy and multiple biopsy sampling in order to detect histological dysplasia or abnormal aneuploid DNA content, or both. Biopsy specimens were taken from 10 predetermined locations in the colon and rectum. No patient had definite dysplasia but three displayed DNA aneuploidy (12.5%), and one of these subsequently developed a carcinoma (Dukes' C at operation) in the ascending colon. No concomitant dysplasia was detected but the carcinoma as well as other parts of the mucosa were DNA aneuploid. It is concluded that dysplasia is rare in patients with Crohn's colitis, but findings of DNA aneuploidy warrant vigilance in follow up as this may indicate impending carcinoma. Further prospective studies are needed before the predictive value of DNA aneuploidy can be determined and before general recommendations of colonoscopic surveillance, as in longstanding ulcerative colitis, can be made.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Craft C. F., Mendelsohn G., Cooper H. S., Yardley J. H. Colonic "precancer" in Crohn's disease. Gastroenterology. 1981 Mar;80(3):578–584. [PubMed] [Google Scholar]
  2. Farmer R. G., Whelan G., Fazio V. W. Long-term follow-up of patients with Crohn's disease. Relationship between the clinical pattern and prognosis. Gastroenterology. 1985 Jun;88(6):1818–1825. doi: 10.1016/0016-5085(85)90006-x. [DOI] [PubMed] [Google Scholar]
  3. Fireman Z., Grossman A., Lilos P., Hacohen D., Bar Meir S., Rozen P., Gilat T. Intestinal cancer in patients with Crohn's disease. A population study in central Israel. Scand J Gastroenterol. 1989 Apr;24(3):346–350. doi: 10.3109/00365528909093058. [DOI] [PubMed] [Google Scholar]
  4. Gollop J. H., Phillips S. F., Melton L. J., 3rd, Zinsmeister A. R. Epidemiologic aspects of Crohn's disease: a population based study in Olmsted County, Minnesota, 1943-1982. Gut. 1988 Jan;29(1):49–56. doi: 10.1136/gut.29.1.49. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Greenstein A. J., Sachar D. B., Smith H., Janowitz H. D., Aufses A. H., Jr A comparison of cancer risk in Crohn's disease and ulcerative colitis. Cancer. 1981 Dec 15;48(12):2742–2745. doi: 10.1002/1097-0142(19811215)48:12<2742::aid-cncr2820481231>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  6. Gyde S. N., Prior P., Allan R. N., Stevens A., Jewell D. P., Truelove S. C., Lofberg R., Brostrom O., Hellers G. Colorectal cancer in ulcerative colitis: a cohort study of primary referrals from three centres. Gut. 1988 Feb;29(2):206–217. doi: 10.1136/gut.29.2.206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gyde S. N., Prior P., Macartney J. C., Thompson H., Waterhouse J. A., Allan R. N. Malignancy in Crohn's disease. Gut. 1980 Dec;21(12):1024–1029. doi: 10.1136/gut.21.12.1024. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hamilton S. R. Colorectal carcinoma in patients with Crohn's disease. Gastroenterology. 1985 Aug;89(2):398–407. doi: 10.1016/0016-5085(85)90343-9. [DOI] [PubMed] [Google Scholar]
  9. Hammarberg C., Slezak P., Tribukait B. Early detection of malignancy in ulcerative colitis. A flow-cytometric DNA study. Cancer. 1984 Jan 15;53(2):291–295. doi: 10.1002/1097-0142(19840115)53:2<291::aid-cncr2820530218>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  10. Lennard-Jones J. E., Morson B. C., Ritchie J. K., Williams C. B. Cancer surveillance in ulcerative colitis. Experience over 15 years. Lancet. 1983 Jul 16;2(8342):149–152. doi: 10.1016/s0140-6736(83)90129-0. [DOI] [PubMed] [Google Scholar]
  11. Löfberg R., Broström O., Karlén P., Tribukait B., Ost A. Colonoscopic surveillance in long-standing total ulcerative colitis--a 15-year follow-up study. Gastroenterology. 1990 Oct;99(4):1021–1031. doi: 10.1016/0016-5085(90)90622-8. [DOI] [PubMed] [Google Scholar]
  12. Löfberg R., Tribukait B., Ost A., Broström O., Reichard H. Flow cytometric DNA analysis in longstanding ulcerative colitis: a method of prediction of dysplasia and carcinoma development? Gut. 1987 Sep;28(9):1100–1106. doi: 10.1136/gut.28.9.1100. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. McKinley M. J., Budman D. R., Kahn E. High grade dysplasia in Crohn's colitis characterized by flow cytometry. J Clin Gastroenterol. 1987 Aug;9(4):452–455. doi: 10.1097/00004836-198708000-00019. [DOI] [PubMed] [Google Scholar]
  14. Melville D. M., Jass J. R., Shepherd N. A., Northover J. M., Capellaro D., Richman P. I., Lennard-Jones J. E., Ritchie J. K., Andersen S. N. Dysplasia and deoxyribonucleic acid aneuploidy in the assessment of precancerous changes in chronic ulcerative colitis. Observer variation and correlations. Gastroenterology. 1988 Sep;95(3):668–675. doi: 10.1016/s0016-5085(88)80013-1. [DOI] [PubMed] [Google Scholar]
  15. Pera A., Bellando P., Caldera D., Ponti V., Astegiano M., Barletti C., David E., Arrigoni A., Rocca G., Verme G. Colonoscopy in inflammatory bowel disease. Diagnostic accuracy and proposal of an endoscopic score. Gastroenterology. 1987 Jan;92(1):181–185. [PubMed] [Google Scholar]
  16. Petras R. E., Mir-Madjlessi S. H., Farmer R. G. Crohn's disease and intestinal carcinoma. A report of 11 cases with emphasis on associated epithelial dysplasia. Gastroenterology. 1987 Dec;93(6):1307–1314. [PubMed] [Google Scholar]
  17. Reid B. J., Haggitt R. C., Rubin C. E., Rabinovitch P. S. Barrett's esophagus. Correlation between flow cytometry and histology in detection of patients at risk for adenocarcinoma. Gastroenterology. 1987 Jul;93(1):1–11. [PubMed] [Google Scholar]
  18. Riddell R. H., Goldman H., Ransohoff D. F., Appelman H. D., Fenoglio C. M., Haggitt R. C., Ahren C., Correa P., Hamilton S. R., Morson B. C. Dysplasia in inflammatory bowel disease: standardized classification with provisional clinical applications. Hum Pathol. 1983 Nov;14(11):931–968. doi: 10.1016/s0046-8177(83)80175-0. [DOI] [PubMed] [Google Scholar]
  19. Simpson S., Traube J., Riddell R. H. The histologic appearance of dysplasia (precarcinomatous change) in Crohn's disease of the small and large intestine. Gastroenterology. 1981 Sep;81(3):492–501. [PubMed] [Google Scholar]
  20. Softley A., Clamp S. E., Watkinson G., Bouchier I. A., Myren J., de Dombal F. T. The natural history of inflammatory bowel disease: has there been a change in the last 20 years? Scand J Gastroenterol Suppl. 1988;144:20–23. [PubMed] [Google Scholar]
  21. Warren R., Barwick K. W. Crohn's colitis with carcinoma and dysplasia. Report of a case and review of 100 small and large bowel resections for Crohn's disease to detect incidence of dysplasia. Am J Surg Pathol. 1983 Mar;7(2):151–159. [PubMed] [Google Scholar]
  22. Weedon D. D., Shorter R. G., Ilstrup D. M., Huizenga K. A., Taylor W. F. Crohn's disease and cancer. N Engl J Med. 1973 Nov 22;289(21):1099–1103. doi: 10.1056/NEJM197311222892101. [DOI] [PubMed] [Google Scholar]

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