Narrow-band imaging with magnifying endoscopy for Peyer's patches is useful in predicting the recurrence of remissive patients with ulcerative colitis.
- Author:
Satoshi HIYAMA
1
;
Hideki IIJIMA
;
Syoichiro KAWAI
;
Akira MUKAI
;
Eri SHIRAISHI
;
Shuko IWATANI
;
Toshio YAMAGUCHI
;
Manabu ARAKI
;
Yoshito HAYASHI
;
Shinichiro SHINZAKI
;
Tsunekazu MIZUSHIMA
;
Masahiko TSUJII
;
Tetsuo TAKEHARA
Author Information
- Publication Type:Original Article
- Keywords: Colitis, ulcerative; Peyer's patch; Narrow-band imaging
- MeSH: Colitis, Ulcerative*; Endoscopy*; Humans; Hyperemia; Ileum; Immunity, Mucosal; Multivariate Analysis; Peyer's Patches*; Recurrence*; Risk Factors; Ulcer*
- From:Intestinal Research 2016;14(4):314-321
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Peyer's patches (PPs) are aggregates of lymphoid follicles that are mainly located in the distal ileum; they play a major role in mucosal immunity. We recently reported that patients with ulcerative colitis (UC) have alterations in PPs that can be detected using narrow-band imaging with magnifying endoscopy (NBI-ME). However, the usefulness of NBI-ME in UC treatment as a whole is still unknown. METHODS: We collected NBI-ME images of PPs from 67 UC patients who had undergone ileocolonoscopy. We evaluated changes in the villi using the "villi index," which is based on three categories: irregular formation, hyperemia, and altered vascular network pattern. The patients were divided into two groups on the basis of villi index: low (L)- and high (H)-types. We then determined the correlation between morphological alteration of the PPs and various clinical characteristics. In 52 patients who were in clinical remission, we also analyzed the correlation between NBI-ME findings of PPs and clinical recurrence. RESULTS: The time to clinical recurrence was significantly shorter in remissive UC patients with H-type PPs than in those with L-type PPs (P<0.01). Moreover, PP alterations were not correlated with age, sex, disease duration, clinical activity, endoscopic score, or extent of disease involvement. Multivariate analysis revealed that the existence of H-type PPs was an independent risk factor for clinical recurrence (hazard ratio, 3.3; P<0.01). CONCLUSIONS: UC patients with morphological alterations in PPs were at high risk of clinical relapse. Therefore, to predict the clinical course of UC, it may be useful to evaluate NBI-ME images of PPs.
