BACKGROUND AND AIMS When colon polyps are removed in the setting of inflammatory bowel disease (IBD) involving the large intestine, biopsy sampling of the flat mucosa surrounding such polyps have been recommended, but there are no data to support this practice. METHODS We reviewed endoscopic and pathologic findings in IBD patients who had dysplastic polyps removed and biopsy sampling of the adjacent flat mucosa. We assessed risk for subsequent neoplasia based on the presence or absence of dysplasia in the peri-polyp flat mucosa and based on number and grade of index polypoid lesions. Kaplan-Meier survival analysis was performed. RESULTS Fifty-six IBD patients (68% ulcerative colitis [UC]) underwent 102 colonoscopies, in which 129 dysplastic polyps were resected. Five hundred three biopsy procedures of the surrounding flat mucosa were performed (mean, 3.9 biopsy samples per polyp), of which 16 (3.2%) were dysplastic. Thirty-four patients (21 UC) had follow-up in a median of 1.7 years (range, .02-15) and 147 colonoscopies. The presence of dysplasia in peri-polyp biopsy specimens during index colonoscopy was not associated with risk of developing high-grade dysplasia (HGD) or cancer (Pearson χ2 test = .19). The size and number of dysplastic polyps were not predictive of neoplastic outcomes, but the probability of developing subsequent advanced neoplasia for polypoid low-grade dysplasia was 18%, 29%, and 40% by 1, 3, and 5 years, respectively, and for polypoid HGD was 50%, 60%, and 70% by 1, 3, and 5 years, respectively (hazard ratio, 7.0; standard error, 4.8). CONCLUSIONS In patients with IBD-associated colitis, biopsy sampling of the mucosa adjacent to discrete dysplastic polypoid lesions are low yield and do not predict findings in follow-up examinations. However, the grade of dysplasia of the polyp itself is predictive of subsequent advanced neoplasia.

中文翻译：

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评估炎症性肠病患者扁平粘膜的息肉周围活检标本。

背景和目的 当在涉及大肠的炎症性肠病 (IBD) 的情况下切除结肠息肉时，建议对这种息肉周围的扁平粘膜进行活检取样，但没有数据支持这种做法。方法 我们回顾了 IBD 患者的内镜和病理学发现，这些患者切除了发育异常的息肉，并对邻近的扁平粘膜进行了活检。我们根据息肉周围扁平粘膜是否存在异型增生以及指标息肉样病变的数量和等级来评估后续肿瘤形成的风险。进行了 Kaplan-Meier 生存分析。结果 56 名 IBD 患者（68% 为溃疡性结肠炎 [UC]）接受了 102 次结肠镜检查，其中 129 颗发育不良的息肉被切除。对周围扁平粘膜进行了 503 次活检（平均每个息肉 3.9 个活检样本），其中 16 个（3.2%）为发育不良。34 名患者 (21 UC) 接受了中位 1.7 年（范围，0.02-15）的随访和 147 次结肠镜检查。在结肠镜检查期间息肉周围活检标本中异型增生的存在与发生高度异型增生 (HGD) 或癌症的风险无关（Pearson χ2 检验 = .19）。异型增生性息肉的大小和数量不能预测肿瘤结果，但息肉样低度异型增生在 1 年、3 年和 5 年时发生后续晚期肿瘤的概率分别为 18%、29% 和 40%，并且息肉样 HGD 在 1、3 和 5 年时分别为 50%、60% 和 70%（风险比，7.0；标准误差，4.8）。结论 在 IBD 相关性结肠炎患者中，离散的发育不良性息肉样病变附近的粘膜活检取样率低，并且不能预测后续检查的结果。然而，息肉本身的异型增生等级可预测随后的晚期瘤形成。