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79] Kundu R, Blonski W, Su C, et al. High-grade dysplasia in adenoma-like mass lesions is not an indication for colectomy in patients with ulcerative colitis. Am J Gastroenterol 2005;100(9)(Suppl 1):S303. [80] Farraye FA, Waye JD, Moscandrew M, et al. Variability in the endoscopic diagnosis and clinical management of adenoma-like and non adenoma- like DALMS in patients with ulcerative colitis. Gastrointest Endosc 2005;61:AB250. [81] Delaunoit T, Limburg PJ, Goldberg RM, et al. Colorectal cancer prognosis among patients with inflammatory bowel disease.

For instance, adenoma-like DALMs possess a low risk for synchronous or metachronous neoplasia, and, thus, may be treated conservatively by polypectomy and continued surveillance. Nonadenoma-like DALMs have a high risk for concurrent and subsequent malignancy, and, as a result, often require colectomy as the definitive form of treatment [66,68]. Some recent data suggest that most elevated dysplastic lesions in IBD are, in fact, adenoma-like. For instance, in a study by Rutter and colleagues [13], 56 patients who had UC who developed dysplasia (flat or elevated) in the course of a 14-year surveillance program at St.

Decreased expression of CD44, alpha-catenin, and deleted colon carcinoma and altered expression of beta-catenin in ulcerative colitisassociated dysplasia and carcinoma, as compared with sporadic colon neoplasms. Cancer 2000;89:733–40. [78] Selaru FM, Xu Y, Yin J, et al. Artificial neural networks distinguish among subtypes of neoplastic colorectal lesions. Gastroenterology 2002;122:606–13. [79] Kundu R, Blonski W, Su C, et al. High-grade dysplasia in adenoma-like mass lesions is not an indication for colectomy in patients with ulcerative colitis.

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