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

Abstract

The findings of magnifying colonoscopy in patients with quiescent UC is useful for predicting relapse and is associated with histological grade of inflammation.

Magnifying Endoscopic Findings Can Predict Clinical Outcome during Long-Term Follow-Up of More Than 12 Months in Patients with Ulcerative Colitis

“…Watanabe et al reported that the magnify-regular group, as mentioned above, had the significant lower relapse rate within 12 months compared to the magnify-irregular and magnify-defect group [7]. In the other study, UC relapse during 12 months of follow-up was found to be increased with worsening grade by the 4 ME classifications [6].…”

“…In the similar way using the indigo carmine spray, there was a report on the modified 6-grading system by adding the ME appearance of polypoid mucosal tags [13]. A recent study claimed the 3-grading system of ME findings with the indigo carmine spray consisting of magnify-regular, magnify-irregular, and magnify-defect in patients with the inactive disease [7]. On the other hand, Nishio et al classified the ME features after staining with an absorptive dye, methylene blue into 4 grades in the rectal mucosa of inactive UC patients [6], similar to the present study where crystal violet was employed as the absorptive dye.…”

“…Again, narrow band imaging (NBI) is an innovative optical technology to enhance hemoglobin-rich areas such as blood vessels [4], and, coupled with NBI, ME depicts the superficial microvascular architectures in the neoplastic lesions [5]. Recent studies have showed that the ME features of colorectal mucosa in UC patients may be associated with histopathological activity of UC and enable the prediction of relapse even in the inactive disease [6, 7]. However, the reported observation periods for the relapse assessment were relatively short-term within 12 months in earlier studies.…”

Clinical relevance of endoscopic assessment of inflammation in ulcerative colitis: Can endoscopic evaluation predict outcomes?

“…Regular pit pattern seen under MC is associated with a significantly reduced risk of relapse[9,10]. Patients with distorted MVP, abnormalities in epithelium or pit pattern have a higher grade of inflammation on histology and relapse subsequently[9-11,46,47]. In one recent study MC with NBI-lead target biopsies seems to predict long term outcomes[48].…”

“…Histologically active disease is associated with greater risk of subsequent relapse[6-8]. Studies using standard WLE fail to predict relapse in quiescent UC[5,7,8], whereas studies using advanced endoscopic imaging modalities seem to hold promise[9-11]. …”