Background Colonoscopy with pan-chromoendoscopy (CE) is superior to standard colonoscopy in detecting neoplasia in patients with IBD. Performing random biopsies in unsuspicious mucosa after CE remains controversial. Methods Consecutive patients with IBD who underwent surveillance colonoscopy using CE were prospectively included. The standardised procedure used CE, performed targeted biopsies or endoscopic resection on suspicious lesions and then quadrant random biopsies every 10 cm. A panel of five expert pathologists reviewed histological slides with dysplasia. Logistic regression model was used to evidence the factors associated with neoplasia in any or in random biopsies. Results 1000 colonoscopes were performed in 1000 patients (495 UC, 505 Crohn's colitis). In 82 patients, neoplasia was detected from targeted biopsies or removed lesions, and among them dysplasia was detected also by random biopsies in 7 patients. Importantly, in 12 additional patients dysplasia was only detected by random biopsies. Overall, 140 neoplastic sites were found in 94 patients, 112 (80%) from targeted biopsies or removed lesions and 28 (20%) by random biopsies. The yield of neoplasia by random biopsies only was 0.2% per-biopsy (68/31 865), 1.2% per-colonoscopy (12/1000) but 12.8% per-patient with neoplasia (12/94). Dysplasia detected by random biopsies was associated with a personal history of neoplasia, a tubular appearing colon and the presence of primary sclerosing cholangitis (PSC). Conclusions Despite their low yield, random biopsies should be performed in association with CE in patients with IBD with a personal history of neoplasia, concomitant PSC or a tubular colon during colonoscopy. Trial registration number IRB 001508, Paris 7 University.

中文翻译：

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随机活检是否仍可用于检测接受染色质内窥镜检查的结肠镜检查的 IBD 患者的肿瘤？

背景 使用泛色素内窥镜 (CE) 的结肠镜检查在检测 IBD 患者的肿瘤方面优于标准结肠镜检查。CE 后在不可疑的粘膜中进行随机活检仍然存在争议。方法前瞻性地纳入了连续使用 CE 进行结肠镜检查的 IBD 患者。标准化程序使用 CE，对可疑病变进行靶向活检或内镜切除，然后每 10 厘米进行象限随机活检。一个由五名专家病理学家组成的小组审查了发育不良的组织学载玻片。逻辑回归模型用于证明任何或随机活检中与瘤形成相关的因素。结果 1000 名患者（495 UC，505 克罗恩结肠炎）进行了 1000 次结肠镜检查。在 82 名患者中，从靶向活检或切除的病灶中检测到瘤形成，其中7例患者随机活检也检测到异型增生。重要的是，在另外 12 名患者中，仅通过随机活检检测到发育不良。总体而言，在 94 名患者中发现了 140 个肿瘤部位，其中 112 个（80%）来自靶向活检或切除的病灶，28 个（20%）来自随机活检。随机活检的瘤形成率仅为每次活检 0.2% (68/31 865)，每次结肠镜检查 (12/1000) 为 1.2%，但每位瘤形成患者 (12/94) 为 12.8%。随机活检检测到的发育异常与个人肿瘤病史、管状结肠和原发性硬化性胆管炎 (PSC) 的存在有关。结论 尽管其产量低，但在结肠镜检查期间，对于有肿瘤形成、伴随 PSC 或管状结肠的 IBD 患者，应结合 CE 进行随机活检。