Magnifying Colonoscopic Features of Ulcerative Colitis Reflect Histologic Inflammation

Kitajima, Masaki; Tanaka, Shinji; Sumii, Masaharu; Ueno, Yoshitaka; Ito, Masanori; Kitadai, Yasuhiko; Yoshihara, Masaharu; Shimamoto, Fumio; Haruma, Ken; Chayama, Kazuaki

doi:10.1097/00054725-200411000-00007

Cited by 36 publications

(25 citation statements)

References 8 publications

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“…Therefore, the current pit pattern classification system may not be fully applicable in cases of UC. The pit pattern of the regenerative hyperplastic villous mucosa in UC is difficult to distinguish from neoplastic pit patterns because the pits characteristic of UC can become elongated or irregular, depending on the degree of inflammation 26. We have reported instead that discovery of a high residual density of pits and irregular pit margins upon magnification after indigo carmine dye spraying is useful for differentiating between colitis-associated neoplastic and non-neoplastic lesions 21.…”

Section: Discussionmentioning

confidence: 97%

Clinical usefulness of narrow band imaging magnifying colonoscopy for assessing ulcerative colitis-associated cancer/dysplasia

et al. 2016

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Background and study aims: Colitis-associated cancer/dysplasia (CC/D) can affect the life expectancy of patients with ulcerative colitis (UC). Although the utility of magnifying chromocolonoscopy has been shown, the use of optical magnification with narrow band imaging (NBI) for distinguishing CC/D from non-neoplastic lesions in patients with UC has not been reported. We evaluated whether endoscopic findings are distinguishing and thus assessed the clinical usefulness of NBI magnification for differentiating UC-associated lesions. Patients and methods: The study involved 27 patients diagnosed and treated at Hiroshima University Hospital between September 2005 and March 2015: a neoplasia group (16 lesions) and a non-neoplasia group (17 lesions). The neoplasias comprised 9 dysplastic lesions, 5 intramucosal carcinomas, and 2 submucosal carcinomas, and 17 non-neoplastic lesions. Targeted biopsy samples of suspicious lesions detected by conventional colonoscopy were classified pathologically as neoplastic or non-neoplastic, and NBI magnifying colonoscopy findings (i. e., the surface [unclear/regular/irregular/amorphous] and vascular [same as the background mucosa/regular/irregular/avascular] patterns) of the 2 lesion types were compared. Results: Irregular/amorphous surface patterns were significantly more common in neoplastic lesions than in non-neoplastic lesions (81 % [13/16] vs. 18 % [3/17], respectively, P < 0.001). Irregular/avascular vessel pattern tended to be more common in neoplastic lesions (75 % [12/16] vs. 41 % [7/17], respectively). The surface pattern correctly predicted 82 % of neoplastic lesions, and the vessel pattern correctly predicted 67 % of non-neoplastic lesions. The 2 endoscopic findings together correctly predicted 91 % of neoplastic lesions. Conclusion: Surface pattern, determined by magnifying colonoscopy with NBI, is useful for differenting between UC-associated neoplastic and non-neoplastic lesions.

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Section: Discussionmentioning

confidence: 97%

Clinical usefulness of narrow band imaging magnifying colonoscopy for assessing ulcerative colitis-associated cancer/dysplasia

et al. 2016

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“…Surface pit pattern classification with ME is known to have a good association with the histopathological diagnosis of colorectal tumor [18]. Similarly, recent studies have shown that ME findings are significantly correlated with histological grades [27, 28]. Of note, it is reported that ME could be useful in assessing microscopic inflammatory features of UC that cannot be determined by white light colonoscopic examination [27, 28].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, recent studies have shown that ME findings are significantly correlated with histological grades [27, 28]. Of note, it is reported that ME could be useful in assessing microscopic inflammatory features of UC that cannot be determined by white light colonoscopic examination [27, 28]. The use of ME in UC is relatively new and different ME classifications have been proposed to date [18, 27, 28].…”

Section: Discussionmentioning

confidence: 99%

“…Of note, it is reported that ME could be useful in assessing microscopic inflammatory features of UC that cannot be determined by white light colonoscopic examination [27, 28]. The use of ME in UC is relatively new and different ME classifications have been proposed to date [18, 27, 28]. Further studies are required to determine the classifications that most accurately represent and predict the patient’s clinical status and outcome.…”

Section: Discussionmentioning

confidence: 99%

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Correlation of Fecal Markers with Magnifying Endoscopic Stratification in Patients with Ulcerative Colitis Who Are in Clinical Remission

et al. 2018

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Background: Maintenance of mucosal healing is recommended during the treatment of ulcerative colitis (UC). However, symptoms of UC often do not reflect mucosal disease activity. Fecal markers such as calprotectin, lactoferrin, and hemoglobin have been reported to correlate well with the Mayo endoscopic subscore (MES) and are being considered alternative monitoring tools in endoscopy. Ulcerative Colitis Endoscopic Index of Severity (UCEIS) is a new and more detailed endoscopic scoring system compared to MES. Furthermore, magnifying endoscopic stratification (ME) based on alterations in the mucosal surface pit patterns is noted in UC. However, the association between fecal markers and UCIES and magnifying endoscopy is relatively unexplored. Summary: This study investigated the association between the aforementioned fecal markers and MES, UCEIS, and ME in patients with UC in clinical remission. This prospective study included 60 patients with UC in clinical remission who underwent colonoscopy at the Nagasaki University Hospital between June 2015 and November 2016. A significant correlation was observed between MES and all fecal markers. Notably, the fecal markers correlated well with UCEIS (calprotectin Spearman’s correlation coefficient [r] = 0.54, p < 0.0001; lactoferrin r = 0.56, p < 0.0001; and hemoglobin r = 0.43, p < 0.001). Furthermore, ME findings correlated significantly with calprotectin (r = 0.50, p = 0.0002) and lactoferrin (r = 0.46, p = 0.0006) levels and slightly with hemoglobin (r = 0.28, p = 0.043) levels. Moreover, each cutoff level of fecal calprotectin, lactoferrin, or hemoglobin had a high sensitivity and specificity for the detection of MES = 0, UCEIS = 0, ME = A, for predicting mucosa healing. Key Messages: Fecal markers correlated not only with MES but also with UCEIS and ME and should be useful for monitoring patients with UC in clinical remission.

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“…However, in these studies the groups in active and remission phases that were detected by colonoscopy were mixed. Kunihiro et al 35 also reported the correlation between histological and magnifying colonoscopy findings. However, that report only described the magnifying colonoscopy findings of UC from an active stage to a remission stage.…”

Section: Histological Findingsmentioning

confidence: 92%

Magnifying colonoscopy used to predict disease relapse in patients with quiescent ulcerative colitis

Watanabe

Sumioka

Hiramoto

et al. 2009

Inflammatory Bowel Diseases

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Magnifying Colonoscopic Features of Ulcerative Colitis Reflect Histologic Inflammation

Abstract: Magnifying colonoscopy is useful for determining the degree of histologic change without biopsy in patients with ulcerative colitis.

Cited by 36 publications

References 8 publications

Clinical usefulness of narrow band imaging magnifying colonoscopy for assessing ulcerative colitis-associated cancer/dysplasia

Clinical usefulness of narrow band imaging magnifying colonoscopy for assessing ulcerative colitis-associated cancer/dysplasia

Correlation of Fecal Markers with Magnifying Endoscopic Stratification in Patients with Ulcerative Colitis Who Are in Clinical Remission

Magnifying colonoscopy used to predict disease relapse in patients with quiescent ulcerative colitis

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