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Target biopsy or step biopsy? Optimal surveillance for ulcerative colitis: a Japanese nationwide randomized controlled trial

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Abstract

Colorectal cancer is one of the complications of ulcerative colitis (UC) and the risk of cancer increases as the duration of the disease becomes longer. Surveillance colonoscopy has been considered to be important for the early detection and early treatment of colorectal cancer, especially in longstanding UC. Because it is not always easy to detect neoplastic lesions in UC endoscopically, guidelines recommend the use of step biopsy in surveillance, in which either 4 biopsy specimens for every 10 cm or a total of 33 or more biopsy specimens are obtained. However, it has been pointed out that a step biopsy obtaining several tens of biopsy specimens may not be an ideal method in terms of invasiveness to the patient or medical cost. Instead of step biopsy, recent studies report the usefulness of target biopsy, in which biopsy tissues are obtained only from regions suspected of neoplasia. Therefore, the Research Group for Intractable Inflammatory Bowel Disease of the Ministry of Health, Labour and Welfare of Japan has initiated a randomized controlled study to compare the efficacy of step biopsy and target biopsy. The present article gives an introduction to this ongoing randomized controlled trial in Japan.

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Authors and Affiliations

  1. Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan

    Toshiaki Watanabe

  2. Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan

    Yoichi Ajioka

  3. Department of Lower Gastroenterology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Takayuki Matsumoto & Nobuyuki Hida

  4. Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Naoki Tomotsugu

  5. Department of Preventive Medicine and Public Health, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Toru Takebayashi

  6. Kitasao University, 5-9-1 Shirokane, Minato-ku, Tokyo, 108-8641, Japan

    Eisuke Inoue

  7. Department of Gastroenterology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Bunei Iizuka

  8. Cancer Institute Ariake Hospital, 3-8-1 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Masahiro Igarashi

  9. Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Yasushi Iwao

  10. Digestive Disease Center, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki, Yokohama, 224-8503, Japan

    Kazuo Ohtsuka & Shin-ei Kudo

  11. Department of Gastroenterology, Kitasato University East Hospital, 2-1-1 Asamizodai, Minami, Sagamihara, Kanagawa, 252-0380, Japan

    Kiyonori Kobayashi

  12. Kitasato University East Hospital, 2-1-1 Asamizodoi, Minami, Sagamihara, Kanagawa, 252-0380, Japan

    Miwa Sada

  13. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Takayuki Matsumoto

  14. Fujita Health University, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan

    Ichiro Hirata

  15. Department of Gastroenterology, Oita University, 1-1 Idaigaoka, Hasama-cho, Yuhu, Oita, 879-5593, Japan

    Kazunari Murakami

  16. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Masakazu Nagahori & Mamoru Watanabe

  17. Department of Gastroenterology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Kenji Watanabe

  18. Department of Medicine, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura, Kanagawa, 247-0056, Japan

    Fumiaki Ueno

  19. Department of Endoscopy, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Shinji Tanaka

  20. Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Toshifumi Hibi

Authors
  1. Toshiaki Watanabe
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  2. Yoichi Ajioka
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  3. Takayuki Matsumoto
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  4. Naoki Tomotsugu
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  5. Toru Takebayashi
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  6. Eisuke Inoue
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  7. Bunei Iizuka
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  8. Masahiro Igarashi
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  9. Yasushi Iwao
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  10. Kazuo Ohtsuka
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  11. Shin-ei Kudo
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  12. Kiyonori Kobayashi
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  13. Miwa Sada
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  14. Takayuki Matsumoto
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  15. Ichiro Hirata
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  16. Kazunari Murakami
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  17. Masakazu Nagahori
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  18. Kenji Watanabe
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  19. Nobuyuki Hida
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  20. Fumiaki Ueno
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  21. Shinji Tanaka
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  22. Mamoru Watanabe
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  23. Toshifumi Hibi
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Corresponding author

Correspondence to Toshiaki Watanabe.

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Watanabe, T., Ajioka, Y., Matsumoto, T. et al. Target biopsy or step biopsy? Optimal surveillance for ulcerative colitis: a Japanese nationwide randomized controlled trial. J Gastroenterol 46 (Suppl 1), 11–16 (2011). https://doi.org/10.1007/s00535-010-0327-0

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  • DOI: https://doi.org/10.1007/s00535-010-0327-0

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