Abstract
Colonoscopic biopsies from 32 patients were studied at the ultrastructural level using a scanning electron microscope (SEM). Sixteen of the 32 patients had a previous diagnosis of total ulcerative colitis (UCR> 10 years) in protracted remission. The colonic mucosa was normal at endoscopic and histologic examinations (UCRN). The remaining 16 patients had normal colonic mucosa, but had an adenoma or an adenocarcinoma elsewhere in the colon. Several ultrastructural parameters were investigated, such as the number of crypts per area, the distance between the crypts, the outline of mucosal units, the number of mucous cells, the outline of absorptive cells, and the number of villi per area. Quantitative determinations of SEM structures (including measurements with an interactive digital image analyzer system; MOP 30, Zeiss Contron) were made. The results showed no significant differences between the various parameters (except for the number of crypts per area) between patients with UCRN and controls. The possibility of a total (or quasi-total)restitutio ad integrum of the colonic mucosa in certain patients with UCR is discussed. An international policy regarding the colonoscopic surveillance of patients with UCRN should be elaborated. It is suggested that the time interval between control colonoscopic biopsies in patients with UCRN should be increased substantially.
Similar content being viewed by others
References
Lennard-Jones JE, Morson BC, Ritchie JK, et al. Cancer in colitis: assessment of the individual risk by clinical and histological criteria. Gastroenterology 1977;73:1280–9.
Morson BC. Precancer and cancer in inflammatory bowel disease. Pathology 1985;17:173–80.
Goldman H, Shields HM. Diagnosis of dysplasia in ulcerative colitis by combined light microscopy and scanning electron microscopy. In Rachmilewitz D, ed. Inflammatory bowel diseases 1986. Boston: Nijhoff, 1986:125–36.
Ransohoff DF, Riddell RH, Levin B. Ulcerative colitis and colonic cancer: problems in assessing the diagnostic usefulness of mucosal dysplasia. Dis Colon Rectum 1985;28:383–8.
Riddell RH, Levin B. Ultrastructure of the “transitional” mucosa adjacent to large bowel carcinoma. Cancer 1977;40:2509–22.
Rubio CA. Ectopic colonic mucosa in ulcerative colitis and in Crohn's disease of the colon. Dis Colon Rectum 1984;27:182–6.
Rubio CA, Johansson C, Slezak P, Ohman U, Hammarberg C. Villous dysplasia: an ominous histologic sign in colitic patients. Dis Colon Rectum 1984;27:283–7.
Rubio CA, Kranz I. The exfoliating cervical epithelial surface in dysplasia, carcinoma in situ and invasive squamous carcinoma. I. Scanning electron microscopic study. Acta Cytol 1976;20:144–50.
Eisenstat LF, Levin B, Golomb HM, Riddell RH. A technique for removing mucus and debris from mucosal surfaces. Scanning Microsc 1976; Part V:263–8.
Fenoglio CM, Richard RM, Kaye GI. Comparative electronmicroscopic features of normal, hyperplastic, and adenomatous human colonic epithelium. Gastroenterology 1975;69:100–9.
Siew S. The application of scanning electron microscopy in the clinical investigation of the human colon. Scanning Microsc 1983;4:1911–29.
Shields HM, Bates ML, Goldman H, et al. Scanning electron microscopic appearance of chronic ulcerative colitis with and without dysplasia. Gastroenterology 1985;89:62–72.
Rubio CA, Johnsson C, Uribe A, Kock Y. A quantitative method of estimating inflammation in the rectal mucosa: IV. Ulcerative colitis in remission. Scand J Gastroenterol 1984;19:525–30.
Author information
Authors and Affiliations
Additional information
Supported by grants from the Karolinska Institute and the Cancer Society of Stockholm.
About this article
Cite this article
Rubio, C.A., May, I. & Slezak, P. Ulcerative colitis in protracted remission. Dis Colon Rectum 31, 939–944 (1988). https://doi.org/10.1007/BF02554890
Issue Date:
DOI: https://doi.org/10.1007/BF02554890