Bioptical differential diagnosis of adenomas, dysplasias and carcinomas inpatients with ulcerative colitis

Background and aim. At the beginning of the nineteen-nineties we developed criteria for the differential diagnosis of neoplasms in ulcerative colitis. The aim of the present analysis was to check these criteria in a large ser ies of patients. Patients and methods: A fetal of 236 ulcerative colitis patients with neopl astic lesions - 29.2% adenomas (A), 47.1% dysplasias (D) and 19.5% carcinom as (C) - were investigated. Results. The patients groups differed in terms of the following variables. age distribution (A: 62.2 +/- 12.4 years, D: 47.9 +/- 17.7 years, C: 51.2 /- 16.2 years); duration of ulcerative colitis to the first appearance of t he neoplasm (A: 8 +/- 7.4 years, D: 10.9 +/- 9.5 years, C: 14 +/- 95 years) ; frequency of total ulcerative colitis (A: 30.2%; D, 56 1%, C.. 50.8%); fr equency of distal ulcerative colitis TA. 19.8%, D: 0%, C: 0%) and frequency of solitary (A: 62.0%, D: 47.3%)) and multiple lesions (A: 38.0%, D: 52.7% ). Additional molecular-genetic investigations revealed differences in p53 and bcl-2 expression (p53: A 4%, D 40%, bcl-2: A 76%, D 30%). DNA cytometri c studies revealed euploidy in ali adenomas, but aneuploidy in 14 out of 19 cases of dysplasia. Conclusion. Diagnostic differentiation between adenoma and dysplasia in pat ients with ulcerative colitis on the basis of clinical, endoscopic, macrosc opic, histological and cytological, as weil as DNA-cytometric and molecular -genetic criteria, appears very likely possible, However, further followup studies are still required.