Endoscopic surveillance of patients with inflammatory bowel disease and primary sclerosing cholangitis – a single center experience

Česká verze

Authors: M. Hlavatý ¹; P. Mačinga ¹; P. Wohl ¹; T. Osadcha ²; P. Drastich ¹
Authors place of work: Klinika hepatogastroenterologie, Institut klinické a experimentální medicíny, Praha ¹; Oddělení elektronických informačních zdrojů a datové vědy, Institut klinické a experimentální medicíny, Praha ²
Published in the journal: Gastroent Hepatol 2025; 79(4): 233-240
Category: Původní práce
doi: https://doi.org/10.48095/ccgh2025233

Summary

Introduction: Patients with primary sclerosing cholangitis (PSC) associated with inflammatory bowel disease (PSCIBD) are at increased risk of colorectal neoplasia. The aim of this study was to assess the incidence of colorectal neoplasia and identify risk factors for their development during long-term endoscopic surveillance in a tertiary center. Methods: This retrospective study included 365 patients with PSC-IBD who were followed between 2007 and 2025, and underwent a total of 2,352 colonoscopies. Demographic and clinical data, endoscopic findings, and histological results were analyzed. Risk factors for dysplasia and carcinoma were assessed using a time-dependent Cox regression model. Results: Dysplasia was detected in 76 patients (20.8%), with a neoplasia detection rate of 9.18%. A total of 216 dysplastic lesions were identified (50.9% from polypectomies and 49.1% from biopsies). Adenocarcinoma was diagnosed in 13 patients (3.6%). Statistically significant risk factors included higher age (HR = 1.03; P = 0.008), biologic therapy (HR = 2.48; P = 0.029), and disease duration (P < 0.001). The Mayo endoscopic subscore showed a positive trend toward significance (HR = 1.27; P = 0.051). Conclusion: Our study confirms the high risk of colorectal neoplasia in patients with PSC-IBD, particularly in older individuals, those with longer disease duration, and those receiving biologic therapy. It highlights the importance of annual surveillance colonoscopies with both targeted and random biopsies.

Keywords:

primary sclerosing cholangitis – inflammatory bowel disease – endoscopic follow-up – colorectal cancer – dysplasia

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ORCID autorů

M. Hlavatý 0009-0007-1718-436X,

P. Mačinga 0000-0003-3699-6914,

P. Wohl 0000-0003-0948-0904,

T. Osadcha 0009-0008-7659-9431,

P. Drastich 0000-0002-5656-9242.

Doručeno/ Submitted: 7. 8. 2025

Přijato/ Accepted: 11. 8. 2025

Korespondenční autor

MU Dr. Mojmír Hlavatý

Klinika hepatogastroenterologie

Institut klinické a experimentální medicíny