Histologic features and predicting prognosis in ulcerative colitis patients with mild endoscopic activity
- Author:
Seung Yong SHIN
1
;
Hee Sung KIM
;
Kisung KIM
;
Chang Won CHOI
;
Jung Min MOON
;
Jeong Wook KIM
;
Hyun Jin JOO
;
Jeongkuk SEO
;
Muhyeon SUNG
;
Chang Hwan CHOI
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2024;39(1):68-76
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:We aimed to evaluate the histologic features predictive of prognosis and correlate them with endoscopic findings in patients with ulcerative colitis (UC) having complete or partial mucosal healing (MH).
Methods:We prospectively collected and reviewed data from patients with UC who underwent colonoscopy or sigmoidoscopy with biopsy. Complete and partial MH were defined as Mayo endoscopic subscores (MESs) of 0 and 1, respectively. Histologic variables, including the Nancy index (NI), predicting disease progression (defined as the need for medication upgrade or hospitalization/surgery), were evaluated and correlated with endoscopic findings.
Results:Overall, 441 biopsy specimens were collected from 194 patients. The average follow-up duration was 14.7 ± 7.4 months. There were 49 (25.3%) and 68 (35.1%) patients with MESs of 0 and 1, respectively. Disease progression occurred only in patients with an MES of 1. NI ≥ 3 was significantly correlated with disease progression during follow-up. Mucosal friability on endoscopy was significantly correlated with NI ≥ 3 (61.1% in NI < 3 vs. 88.0% in NI ≥ 3; p = 0.013).
Conclusions:Histological activity can help predict the prognosis of patients with UC with mild endoscopic activity. Mucosal friability observed on endoscopy may reflect a more severe histological status, which can be a risk factor for disease progression.
