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Louise E. Hunt, FRCS(Ed); M. Robert Eichenberger, BA; Robert Petras, MD; Susan Galandiuk, MD

Arch Surg. 2000;135:582-585.

Background  Patients with ulcerative colitis (UC) have an increased risk of developing colorectal cancer. The current screening protocol involves an annual colonoscopy and biopsy after the patient has had the disease for 8 years. This, however, does not prevent the development of colorectal cancer.

Hypothesis  A microsatellite marker for IBD1 may identify individuals who are at greater risk of developing dysplasia and therefore colorectal cancer.

Design  Case-control study.

Setting  Single surgical practice.

Patients and Methods  DNA was extracted from peripheral leukocytes of 152 patients: 22 with UC and dysplasia; 48 with UC and no dysplasia; 24 with colorectal cancer; and 58 with noninflammatory bowel disease, nonmalignant gastrointestinal tract disease who were used as control patients. A microsatellite marker for IBD1 (D16S541) was amplified by polymerase chain reaction. Genotypes were identified using autoradiography.

Results  Six alleles and 15 genotypes were identified for marker D16S541. Genotype CC was found in 33% (8/24) of cancer patients but only 12% (7/58) of controls (²=5.5; P=.02). Thirty-two percent (7/22) of patients with dysplastic UC also had this genotype, whereas only 8% (4/48) of patients with nondysplastic UC had the genotype (²=4.6; P=.03; vs controls: ²=3.1; P=.08).

Conclusions  This microsatellite marker for IBD1, when combined with other markers, has the potential to be used as a screening tool for colorectal cancer and dysplasia in patients with UC. Such a marker would be of particular use in improving the sensitivity and specificity of the current screening protocol for dysplasia and colorectal cancer for patients with UC.

From the Price Institute of Surgical Research, Department of Surgery, University of Louisville, Louisville, Ky (Drs Hunt and Galandiuk and Mr Eichenberger); and the Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio (Dr Petras).

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