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KMID : 0338420240390010068
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The Korean Journal of Internal Medicine
2024 Volume.39 No. 1 p.68 ~ p.76
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Histologic features and predicting prognosis in ulcerative colitis patients with mild endoscopic activity
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Shin Seung-Yong
Kim Hee-Sung
Kim Ki-Sung
Choi Chang-Won
Moon Jung-Min
Kim Jeong-Wook
Joo Hyun-Jin
Seo Jeong-Kuk
Sung Mu-Hyeon
Choi Chang-Hwan
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Abstract
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Background/Aims: We aimed to evaluate the histologic features predictive of prognosis and correlate them with endoscopic findings in patients with ulcerative colitis (UC) having complete or partial mucosal healing (MH).
Methods: We prospectively collected and reviewed data from patients with UC who underwent colonoscopy or sigmoidoscopy with biopsy. Complete and partial MH were defined as Mayo endoscopic subscores (MESs) of 0 and 1, respectively. Histologic variables, including the Nancy index (NI), predicting disease progression (defined as the need for medication upgrade or hospitalization/surgery), were evaluated and correlated with endoscopic findings.
Results: Overall, 441 biopsy specimens were collected from 194 patients. The average follow-up duration was 14.7 ± 7.4 months. There were 49 (25.3%) and 68 (35.1%) patients with MESs of 0 and 1, respectively. Disease progression occurred only in patients with an MES of 1. NI ≥ 3 was significantly correlated with disease progression during follow-up. Mucosal friability on endoscopy was significantly correlated with NI ≥ 3 (61.1% in NI < 3 vs. 88.0% in NI ≥ 3; p = 0.013).
Conclusions: Histological activity can help predict the prognosis of patients with UC with mild endoscopic activity. Mucosal friability observed on endoscopy may reflect a more severe histological status, which can be a risk factor for disease progression.
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KEYWORD
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Ulcerative colitis, Histology, Endoscopy, Prognosis
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