Abstract：
Patients with inflammatory bowel disease (IBD) are at an increased risk of developing colitis-associated neoplasia (CAN), including colorectal cancer (CRC), through the inflammation-dysplasia-neoplasia pathway. Dysplasia is the most reliable, early and actionable marker for CAN in these patients. While such lesions are frequently encountered, adequate management depends on an accurate assessment, complete resection and close surveillance. With recent advances in endoscopic technologies and research in the field of CAN, the management of dysplastic lesions has significantly improved. The American Gastroenterology Association and Surveillance for Colorectal Endoscopic Neoplasia Detection (SCENIC) provide a guideline framework for approaching dysplastic lesions in patients with IBD. However, there are significant gaps in these recommendations and real-world clinical practice. Accurate lesion assessment remains pivotal for adequate management of CAN. Artificial intelligence-guided modalities are now increasingly being used to aid the detection of these lesions further. As the lesion detection technologies are improving, our armamentarium of resection techniques is also expanding and includes hot or cold polypectomy, endoscopic mucosal resection, endoscopic sub-mucosal dissection and full-thickness resection. With the broadened scope of endoscopic resection, the recommendations regarding surveillance after resection has also changed. Certain patient populations such as those with invisible dysplasia or with prior colectomy and ileal pouch anal anastomosis need special consideration. In the present review, we aim to provide a state-of-the-art summary of the current practice of endoscopic detection, resection and surveillance of dysplasia in patients with IBD and provide some perspective on the future directions based on the latest research.
摘要：
炎症性肠病（IBD）患者发生结肠炎相关瘤形成（CAN）的风险增加，包括结直肠癌（CRC），通过炎症-异型增生-瘤形成途径。发育不良是最可靠的,这些患者的早期和可行的CAN标记。虽然经常遇到这种病变，适当的管理取决于准确的评估，完全切除和密切监测。随着近年来内镜技术的进步和CAN领域的研究,对发育不良性病变的处理有了显著改善.美国胃肠病学协会和结肠直肠内镜瘤变检测（SCENIC）监测为IBD患者处理增生性病变提供了指导框架。然而,这些建议与实际临床实践存在显著差距.准确的病变评估对于适当管理CAN仍然至关重要。人工智能引导的模式现在越来越多地用于进一步帮助检测这些病变。随着病变检测技术的进步，我们的医疗设备的切除技术也在扩大，包括热或冷息肉切除术，内镜下黏膜切除术,内镜黏膜下剥离术和全层切除术。随着内镜切除范围的扩大，关于切除后监测的建议也发生了变化.某些患者群体，例如那些看不见的发育不良或先前进行结肠切除术和回肠袋肛门吻合术的患者，需要特别考虑。在本次审查中，我们的目标是提供一个国家的最先进的内窥镜检测实践的总结，切除和监测IBD患者的异型增生，并根据最新研究对未来的方向提供一些看法。
