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Additional Yield of Random Biopsy in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

  • 0Xijing Hospital of Digestive Diseases, Air Force Medical University (Fourth Military Medical University), Xi'an, China.
Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association +

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July 7, 2024

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July 7, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Random biopsies (RBs) during colorectal cancer surveillance in inflammatory bowel disease patients yield significant additional findings. RBs are particularly beneficial for patients with primary sclerosing cholangitis (PSC) and in centers without high-definition equipment.

Area Of Science

  • Gastroenterology
  • Oncology
  • Medical Diagnostics

Background

  • Limited clinical data exist on the added value of random biopsies (RBs) in colorectal cancer surveillance for inflammatory bowel disease (IBD) patients.
  • Assessing the diagnostic yield of RBs is crucial for optimizing surveillance protocols in this high-risk group.

Purpose Of The Study

  • To systematically review and meta-analyze the additional yield of random biopsies (RBs) during colonoscopy surveillance in patients with inflammatory bowel disease (IBD).
  • To evaluate the impact of factors like study initiation date and primary sclerosing cholangitis (PSC) on RB yield.

Main Methods

  • A systematic literature search was conducted across PubMed, Embase, Web of Science, and Cochrane Library.
  • Data from 37 studies (48 arms, 9051 patients) were pooled to calculate additional yields and detection rates for RBs.
  • Subgroup analyses were performed based on study initiation year and proportion of patients with PSC.

Main Results

  • The additional yield of RBs was 10.34% per patient and 16.20% per lesion.
  • Detection rates were 1.31% per patient and 2.82% per lesion.
  • Yields decreased in studies post-2011 and significantly increased with higher PSC prevalence, reaching 56.05% per patient and 45.22% per lesion in 100% PSC cohorts.

Conclusions

  • Random biopsies offer a significant additional yield in colorectal cancer surveillance for IBD patients.
  • The utility of RBs is influenced by the prevalence of PSC and the availability of high-definition equipment.
  • Incorporating RBs is recommended, especially for IBD patients with PSC and in centers lacking advanced imaging technology.

Keywords:

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