Screening of dysplasia of the colon mucosa and colorectal cancer in patients with ulcerative colitis. Review of literature and meta-analyses

Ulcerative colitis (UC) is a risk factor for inflammation-related dysplasia or colitis-related dysplasia (colitis-associated dysplasia - CAD). This transformation is the result of chronic inflammation, which causes changes in the proliferation, survival and migration of the epithelium through the induction of chemokines and cytokines. There are noticeable differences in the profiles of genetic mutations between CAD in patients with UC and colorectal cancer (CRC) in the general population. Colonoscopy is the leading method of observation and treatment of dysplasia in these patients. There are several methods to improve the quality of endoscopy for better detection of dysplastic or tumor lesions, including the use of high-definition white light examination and colonoscopy with improved image. Recommendations on clinical practice regarding strategies for monitoring UC have been proposed by various gastrointestinal communities, and in general there is agreement between them - if dysplasia is detected, if possible, endoscopic removal of the altered tissue site should be performed. Advanced methods such as endoscopic mucosal resection and endoscopic submucosal dissection were used in the treatment of CAD. However, at the moment, surgical treatment remains the main method of treating such lesions, and in this case, when endoscopic resection is not possible, surgical treatment in the volume of coloprotectomy with subsequent formation of a small intestinal reservoir and ileoanal anastomosis is recommended.