Relationship between endoscopic mucosal healing and histologic inflammation during remission maintenance phase in ulcerative colitis: a retrospective study
Relationship between endoscopic mucosal healing and histologic inflammation during remission maintenance phase in ulcerative colitis: a retrospective study
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DOI：
10.1055/a-0869-7619
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发表时间：
2019-04-01
影响因子：
2.6
通讯作者：
Irisawa, Atsushi
中科院分区：
文献类型：
--
作者：
Kanazawa, Mimari;Takahashi, Fumiaki;Irisawa, Atsushi
背景和研究目的近年来，组织学炎症被认为是溃疡性结肠炎（UC）持续缓解或复发的重要预测因子。在这项研究中，我们回顾性地比较了组织学炎症的严重程度与内镜检查结果在UC患者粘膜愈合（MH）在缓解维持阶段，并探讨组织学愈合是否可以是一个预测因子持续remission.Patients和方法本研究包括166例MH在缓解维持阶段。内镜评价基于马约内镜分项评分（MES），MH定义为MES 0或1。根据Matts分类对组织学炎症的严重程度进行分级。具有Matts 1和2的患者被包括在组织学愈合（HH）组中，而具有Matts 3、4和5的患者被包括在非组织学愈合（NHH）组中。结果MES 0组的缓解维持率明显高于MES 1组（P =0.004）。HH组的发生率显著高于NHH组（P =0.003）。在MES 1组，率显着高于HH亚组比NHH亚组（P =0.030）。结论这项回顾性研究表明，组织学愈合可以预测持续缓解UC患者，组织学炎症检查提供了有用的信息，长期管理UC，特别是在MES 1患者。
Background and study aims Recently, histological inflammation has been suggested to be an important predictor of sustained remission or relapse of ulcerative colitis (UC). In this study, we retrospectively compared severity of histological inflammation with endoscopic findings in UC patients with mucosal healing (MH) in the remission maintenance phase, and investigated whether histological healing could be a predictor of sustained remission.Patients and methods This study included 166 patients with MH in the remission maintenance phase. Endoscopic evaluation was based on the Mayo endoscopic subscore (MES), and MH was defined as MES 0 or 1. Severity of histological inflammation was graded according to the Matts classification. Patients with Matts 1 and 2 were included in the histological healing (HH) group, and those with Matts 3, 4, and 5, in the non-histological healing (NHH) group.In patients with MH, incidence of relapse was compared and analyzed according to severity of histological inflammation.Results The remission maintenance rate was significantly higher in the MES 0 group than in the MES 1 group ( P =0.004). The rate was significantly higher in the HH group than in the NHH group ( P =0.003). Within the MES 1 group, the rate was significantly higher in the HH subgroup than in the NHH subgroup ( P =0.030).Conclusions This retrospective study suggests that histological healing can be a predictor of sustained remission in UC patients, and examination of histological inflammation provides useful information for long-term management of UC, particularly in patients with MES 1.