Use of segmental colorectal lavage cytology during surveillance colonoscopy for detecting dysplastic and cancer cells in patients with ulcerative colitis.

Purpose: To examine whether segmental colorectal lavage cytology (CRLC) during surveillance colonoscopy was useful for detecting dysplastic and cancer cells in ulcerative colitis (UC) patients.

Methods: We examined whether CRLC can detect dysplastic and cancer cells in total colectomy materials of 39 UC patients. After washing the luminal surface of dissected colorectal tissues with saline, the fluid was collected. We also examined whether segmental CRLC during surveillance colonoscopy can detect dysplastic and cancer cells in 45 UC patients. Fluid was collected after washing segmental colorectum including the suspicious region. Cytological specimens were stained with Papanicolaou and immunocytochemically stained with anti-p53 antibody.

Results: Although cancer and dysplastic cells were found by CRLC in 9 and 4 UC patients receiving total colectomy respectively, histology revealed 9 cancer lesions but only 2 dysplastic foci. In segmental CRLC, cancer cells were detected in 2 UC patients and dysplastic cells in 4 UC patients. Biopsy revealed 2 cases with colon cancer lesions but only 2 cases with dysplastic foci.

Conclusions: Segmental CRLC is a less-invasive and effective method in detecting dysplastic and cancer cells in UC patients during surveillance colonoscopy. It could be used as a complementary method for colonoscopy-directed biopsy.