RT Journal Article SR Electronic T1 Real-life chromoendoscopy for neoplasia detection and characterisation in long-standing IBD JF Gut JO Gut FD BMJ Publishing Group Ltd and British Society of Gastroenterology SP 70 OP 78 DO 10.1136/gutjnl-2016-312332 VO 67 IS 1 A1 Sabela Carballal A1 Sandra Maisterra A1 Antonio López-Serrano A1 Antonio Z Gimeno-García A1 María Isabel Vera A1 José Carlos Marín-Garbriel A1 José Díaz-Tasende A1 Lucía Márquez A1 Marco Antonio Álvarez A1 Luis Hernández A1 Luisa De Castro A1 Jordi Gordillo A1 Ignasi Puig A1 Pablo Vega A1 Marco Bustamante-Balén A1 Juan Acevedo A1 Beatriz Peñas A1 María López-Cerón A1 Elena Ricart A1 Miriam Cuatrecasas A1 Mireya Jimeno A1 María Pellisé A1 , YR 2018 UL http://gut.bmj.com/content/67/1/70.abstract AB Objective Outside clinical trials, the effectiveness of chromoendoscopy (CE) for long-standing IBD surveillance is controversial. We aimed to assess the effectiveness of CE for neoplasia detection and characterisation, in real-life.Design From June 2012 to 2014, patients with IBD were prospectively included in a multicentre cohort study. Each colonic segment was evaluated with white light followed by 0.4% indigo carmine CE. Specific lesions' features were recorded. Optical diagnosis was assessed. Dysplasia detection rate between expert and non-expert endoscopists and learning curve were ascertained.Results Ninety-four (15.7%) dysplastic (1 cancer, 5 high-grade dysplasia, 88 low-grade dysplasia) and 503 (84.3%) non-dysplastic lesions were detected in 350 patients (47% female; mean disease duration: 17 years). Colonoscopies were performed with standard definition (41.5%) or high definition (58.5%). Dysplasia miss rate with white light was 40/94 (57.4% incremental yield for CE). CE-incremental detection yield for dysplasia was comparable between standard definition and high definition (51.5% vs 52.3%, p=0.30). Dysplasia detection rate was comparable between expert and non-expert (18.5% vs 13.1%, p=0.20). No significant learning curve was observed (8.2% vs 14.2%, p=0.46). Sensitivity, specificity, and positive and negative predictive values for dysplasia optical diagnosis were 70%, 90%, 58% and 94%, respectively. Endoscopic characteristics predictive of dysplasia were: proximal location, loss of innominate lines, polypoid morphology and Kudo pit pattern III–V.Conclusions CE presents a high diagnostic yield for neoplasia detection, irrespectively of the technology and experience available in any centre. In vivo, CE optical diagnosis is highly accurate for ruling out dysplasia, especially in expert hands. Lesion characteristics can aid the endoscopist for in situ therapeutic decisions.Trial registration number NCT02543762.