Abstract

PANIAGUA ESTEVEZ, Manuel et al. Dysplasia in patients with idiopathic ulcerative colitis of 10 or more years of evolution. Rev cubana med [online]. 2005, vol.44, n.5-6. ISSN 0034-7523.

The development of colorectal cancer in patients with idiopathic ulcerative colitis is closely related to the time of evolution of the disease (more than 10 years) and to its extension (universal). The genesis of cancer is correlated with internal and external factors present in the course of the disease, such as the secondary biliary acids, considered by many as cytotoxic and cancerigenic substances for the colonic mucosa in elevated concentrations. A descriptive prospective study was undertaken in 35 patients with idiopathic ulcerative colitis of 10 or more years of evolution to determine if they had dysplasia. Dysplasia was found in 14 patients (41 %). 93 % had a low grade dysplasia. In the study group, the most frequently endoscopically diagnosed activity grade of idiopathic ulcerative colitis was grade IV (34.3 %). The activity grade of idiopathic ulcerative colitis was related to the dysplasia grade and no significant association was observed between both variables. 78.6 % of the patients with dysplasia presented elevated total biliary acids in feces. Only a moderately differentiated adenocarcinoma was diagnosed in a patient with universal idiopathic ulcerative colitis of more than 20 years of evolution and with elevated total biliary acids in feces. It was concluded that the screening of dysplasia in patients with idiopathic ulcerative colitis of 10 or more years of evolution will allow to carry out a systematic follow-up to adopt an adequate therapeutic conduct to prevent the progression towards malignancy in these patients.

Keywords : Idiopathic ulcerative colitis; dysplasia.

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