EARLY COLORECTAL CANCER ASSOCIATED WITH ULCERATIVE COLITIS : REPORT OF FOUR CASES

Abstract

In patients with longstanding ulcerative colitis (UC), the risk of developing colorectal cancer (CRC) increases steadily and cancer surveillance is widely recommended. We herein report on four cases of early CRC associated with UC, and in every case we could detect the lesions endoscopically and perform the operation successfully. The type IV like pit pattern, called the neoplastic pit pattern of ulcerative colitis (NPUC), was a particularly important indicator to recognize CRC and dysplasia. However, in many cases, to detect flat neoplastic lesions is still difficult in spite of remarkable progress in endoscopic techniques : therefore, further studies are necessary for accurate diagnosis of the lesions. In surveillance colonoscopy, when we can acquire an exact method of finding the lesions, surveillance by targeted biopsies will be more efficient than by non-targeted random biopsies.