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World J Gastrointest Oncol. Mar 15, 2022; 14(3): 646-653
Published online Mar 15, 2022. doi: 10.4251/wjgo.v14.i3.646
Evolving roles of magnifying endoscopy and endoscopic resection for neoplasia in inflammatory bowel diseases
Shintaro Akiyama, Taku Sakamoto, Joshua M Steinberg, Yutaka Saito, Kiichiro Tsuchiya
Shintaro Akiyama, Taku Sakamoto, Kiichiro Tsuchiya, Department of Gastroenterology, University of Tsukuba, Ibaraki 305-8575, Japan
Taku Sakamoto, Yutaka Saito, Endoscopy Division, National Cancer Center Hospital, Tokyo 104-0045, Japan
Joshua M Steinberg, Department of Inflammatory Bowel Disease, Gastroenterology of the Rockies, Denver, CO 80218, United States
Author contributions: Akiyama S designed and performed the research; Akiyama S, Sakamoto T and Saito Y analyzed the data; Akiyama S, Sakamoto T, Steinberg JM and Tsuchiya K wrote the paper.
Conflict-of-interest statement: SA and TS have no relevant disclosures. JMS was on Advisory Board for Pfizer. YS is on Advisory Board for Boston Scientific KT has received grant supports from Takeda Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharmaceutical Corp., and Hitachi Ltd.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shintaro Akiyama, MD, MSc, PhD, Lecturer, Department of Gastroenterology, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan. akiyama@md.tsukuba.ac.jp
Received: September 1, 2021
Peer-review started: September 1, 2021
First decision: December 4, 2021
Revised: December 6, 2021
Accepted: February 12, 2022
Article in press: February 12, 2022
Published online: March 15, 2022
Abstract

Magnifying endoscopy is a useful technique to differentiate neoplasia from non-neoplastic lesions. Data regarding the clinical utility of magnifying endoscopy for neoplasia in patients with inflammatory bowel disease (IBD) has been emerging. While Kudo’s pit pattern types III-V are findings suggestive of neoplasia in non-IBD patients, these pit patterns are predictive of IBD-associated neoplasia as well. However, active chronic inflammatory processes, particularly regenerative changes, can mimic neoplastic pit patterns and may affect a meticulous evaluation of pit pattern diagnosis in patients with IBD. The clinical evidence regarding the utility of magnifying endoscopy with narrow band imaging or endocytoscopy has also been evolving in regard to the diagnosis of IBD-associated neoplasia. These advanced endoscopic techniques are promising for multiple reasons; not only for making an accurate diagnosis of neoplasia, but also in determining if endoscopic resection is appropriate for such lesions in patients with IBD. In this review, we discuss the diagnostic accuracy and limitations of magnifying endoscopy in assessing IBD-associated neoplasia and examine the feasibility and outcomes of endoscopic resection for these lesions.

Keywords: Magnifying endoscopy, Neoplasia, Ulcerative colitis, Inflammatory bowel disease, Endoscopic resection

Core Tip: Magnifying colonoscopies assessing Kudo’s pit patterns or surface/vascular patterns with narrow band imaging are useful techniques to differentiate neoplasia from non-neoplastic lesions. Many investigations have demonstrated the diagnostic utility of magnifying scopes for neoplasia, as well as the feasibility and outcomes of their endoscopic resection in patients with inflammatory bowel disease. We aim to review updated data regarding these important topics.