Pit patterns in rectal mucosa assessed by magnifying colonoscope are predictive of relapse in patients with quiescent ulcerative colitis

• Published in: Gut 2006-12, Vol.55 (12), p.1768-1773
• Main Authors: Nishio, Y, Ando, T, Maeda, O, Ishiguro, K, Watanabe, O, Ohmiya, N, Niwa, Y, Kusugami, K, Goto, H
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biopsy; C reactive protein; Colitis, Ulcerative - drug therapy; Colitis, Ulcerative - immunology; Colitis, Ulcerative - pathology; Colon; Colonoscopy - methods; CRP; DAI; disease activity index; Endoscopy; erythrocyte sedimentation rate; ESR; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; IBD; Inflammation; Inflammatory Bowel Disease; Interleukin-8 - immunology; Intestinal Mucosa - immunology; Intestinal Mucosa - pathology; Laboratories; magnifying colonoscopy; Male; MCS; Medical sciences; Middle Aged; Morphology; Multivariate analysis; Other diseases. Semiology; Patients; Proctitis - drug therapy; Proctitis - immunology; Proctitis - pathology; Prognosis; Prospective Studies; Rectum - immunology; Rectum - pathology; Recurrence; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; WBC; white cell count
• ISSN: 0017-5749; 1468-3288
• DOI: 10.1136/gut.2005.086900

Background: Relapse of ulcerative colitis is difficult to predict by routine colonoscopy. A high-resolution video-magnifying colonoscope with chromoscopy enables the observation of colorectal mucosal pit patterns. Aims: To investigate the association of pit patterns as assessed by magnifying colonoscopy (MCS) with histological inflammation and mucosal chemokine activity in patients with quiescent ulcerative colitis, and to prospectively analyse the prognostic factors that may predict exacerbations. Methods: MCS was performed in 113 patients with ulcerative colitis in remission. Pit patterns in the rectal mucosa were classified into four MCS grades on the basis of size, shape and arrangement. Mucosal interleukin (IL) 8 activity was measured in biopsy specimens of rectal mucosa and the specimens were assessed for histological disease activity. The patients were then followed until relapse or for a maximum of 12 months. Multivariate survival analysis was carried out to determine the independent predictors of clinical relapse. Results: A positive correlation was identified between MCS grade, histological grade (p = 0.001) and mucosal IL8 activity (p