Complete mucosal healing defined by endoscopic Mayo subscore still demonstrates abnormalities by novel high definition colonoscopy and refined histological gradings

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Complete mucosal healing defined by endoscopic Mayo subscore still demonstrates abnormalities by novel high definition colonoscopy and refined histological gradings. / Iacucci, Marietta; Fort Gasia, Miriam; Hassan, Cesare; Panaccione, Remo; Kaplan, Gilaad G; Ghosh, Subrata; Gui, Xianyong.

In: Endoscopy, Vol. 47, No. 8, 08.2015, p. 726-734.

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Iacucci, Marietta ; Fort Gasia, Miriam ; Hassan, Cesare ; Panaccione, Remo ; Kaplan, Gilaad G ; Ghosh, Subrata ; Gui, Xianyong. / Complete mucosal healing defined by endoscopic Mayo subscore still demonstrates abnormalities by novel high definition colonoscopy and refined histological gradings. In: Endoscopy. 2015 ; Vol. 47, No. 8. pp. 726-734.

Bibtex

@article{bfad628012454726abe69c8418e5114c,
title = "Complete mucosal healing defined by endoscopic Mayo subscore still demonstrates abnormalities by novel high definition colonoscopy and refined histological gradings",
abstract = "BACKGROUND AND STUDY AIMS: A novel high definition colonoscopy imaging technique (i-Scan) can characterize, in detail, colonic mucosa in patients with ulcerative colitis, and may provide additional information about mucosal healing. The aim of this study was to create a more refined histological and endoscopic criteria based on this novel technique in order to redefine inflammatory activity and mucosal healing.PATIENTS AND METHODS: A total of 78 patients with ulcerative colitis were assessed by high definition colonoscopy as well as by white light endoscopy (WLE). Mayo endoscopic subscores were assigned to patients according to WLE findings. Mucosal and vascular patterns on high definition colonoscopy were each graded from 1 - 4. A histological scoring system (ECAP system) was designed to reflect all histological changes in ulcerative colitis.RESULTS: The overall high definition imaging scores (mucosal and vascular patterns) were significantly correlated with Mayo endoscopic subscores (rs = 0.86, 95 % confidence interval [CI] 0.79 - 0.91; P < 0.0001). Of those with Mayo endoscopic subscore of 0, 30.4 % had an abnormal mucosal pattern and 73.9 % of them had an abnormal vascular pattern on high definition colonoscopy; a score of 6 or less had a sensitivity of 95.8 % (95 %CI 85.7 % - 99.3 %) and specificity of 75.9 % (95 %CI 56.5 % - 90.0 %) to detect mucosal healing as defined by Mayo endoscopy subscore of 0 or 1. Furthermore, mucosal and vascular pattern scores were also significantly correlated with most parameters of the proposed ECAP score.CONCLUSION: The subtle histological abnormalities underlying the apparently healed mucosa in ulcerative colitis could be detected using high definition colonoscopy and the refined ECAP histology scoring system. These techniques detect residual abnormalities in the majority of patients with seemingly complete mucosal healing by conventional Mayo criteria.",
keywords = "Adult, Aged, Aged, 80 and over, Biopsy, Colitis, Ulcerative, Colon, Colonoscopy, Female, Follow-Up Studies, Humans, Intestinal Mucosa, Male, Middle Aged, Reproducibility of Results, Retrospective Studies, Severity of Illness Index, Young Adult, Journal Article",
author = "Marietta Iacucci and {Fort Gasia}, Miriam and Cesare Hassan and Remo Panaccione and Kaplan, {Gilaad G} and Subrata Ghosh and Xianyong Gui",
note = "{\textcopyright} Georg Thieme Verlag KG Stuttgart · New York.",
year = "2015",
month = aug,
doi = "10.1055/s-0034-1391863",
language = "English",
volume = "47",
pages = "726--734",
journal = "Endoscopy",
issn = "0013-726X",
publisher = "Georg Thieme Verlag",
number = "8",

}

RIS

TY - JOUR

T1 - Complete mucosal healing defined by endoscopic Mayo subscore still demonstrates abnormalities by novel high definition colonoscopy and refined histological gradings

AU - Iacucci, Marietta

AU - Fort Gasia, Miriam

AU - Hassan, Cesare

AU - Panaccione, Remo

AU - Kaplan, Gilaad G

AU - Ghosh, Subrata

AU - Gui, Xianyong

N1 - © Georg Thieme Verlag KG Stuttgart · New York.

PY - 2015/8

Y1 - 2015/8

N2 - BACKGROUND AND STUDY AIMS: A novel high definition colonoscopy imaging technique (i-Scan) can characterize, in detail, colonic mucosa in patients with ulcerative colitis, and may provide additional information about mucosal healing. The aim of this study was to create a more refined histological and endoscopic criteria based on this novel technique in order to redefine inflammatory activity and mucosal healing.PATIENTS AND METHODS: A total of 78 patients with ulcerative colitis were assessed by high definition colonoscopy as well as by white light endoscopy (WLE). Mayo endoscopic subscores were assigned to patients according to WLE findings. Mucosal and vascular patterns on high definition colonoscopy were each graded from 1 - 4. A histological scoring system (ECAP system) was designed to reflect all histological changes in ulcerative colitis.RESULTS: The overall high definition imaging scores (mucosal and vascular patterns) were significantly correlated with Mayo endoscopic subscores (rs = 0.86, 95 % confidence interval [CI] 0.79 - 0.91; P < 0.0001). Of those with Mayo endoscopic subscore of 0, 30.4 % had an abnormal mucosal pattern and 73.9 % of them had an abnormal vascular pattern on high definition colonoscopy; a score of 6 or less had a sensitivity of 95.8 % (95 %CI 85.7 % - 99.3 %) and specificity of 75.9 % (95 %CI 56.5 % - 90.0 %) to detect mucosal healing as defined by Mayo endoscopy subscore of 0 or 1. Furthermore, mucosal and vascular pattern scores were also significantly correlated with most parameters of the proposed ECAP score.CONCLUSION: The subtle histological abnormalities underlying the apparently healed mucosa in ulcerative colitis could be detected using high definition colonoscopy and the refined ECAP histology scoring system. These techniques detect residual abnormalities in the majority of patients with seemingly complete mucosal healing by conventional Mayo criteria.

AB - BACKGROUND AND STUDY AIMS: A novel high definition colonoscopy imaging technique (i-Scan) can characterize, in detail, colonic mucosa in patients with ulcerative colitis, and may provide additional information about mucosal healing. The aim of this study was to create a more refined histological and endoscopic criteria based on this novel technique in order to redefine inflammatory activity and mucosal healing.PATIENTS AND METHODS: A total of 78 patients with ulcerative colitis were assessed by high definition colonoscopy as well as by white light endoscopy (WLE). Mayo endoscopic subscores were assigned to patients according to WLE findings. Mucosal and vascular patterns on high definition colonoscopy were each graded from 1 - 4. A histological scoring system (ECAP system) was designed to reflect all histological changes in ulcerative colitis.RESULTS: The overall high definition imaging scores (mucosal and vascular patterns) were significantly correlated with Mayo endoscopic subscores (rs = 0.86, 95 % confidence interval [CI] 0.79 - 0.91; P < 0.0001). Of those with Mayo endoscopic subscore of 0, 30.4 % had an abnormal mucosal pattern and 73.9 % of them had an abnormal vascular pattern on high definition colonoscopy; a score of 6 or less had a sensitivity of 95.8 % (95 %CI 85.7 % - 99.3 %) and specificity of 75.9 % (95 %CI 56.5 % - 90.0 %) to detect mucosal healing as defined by Mayo endoscopy subscore of 0 or 1. Furthermore, mucosal and vascular pattern scores were also significantly correlated with most parameters of the proposed ECAP score.CONCLUSION: The subtle histological abnormalities underlying the apparently healed mucosa in ulcerative colitis could be detected using high definition colonoscopy and the refined ECAP histology scoring system. These techniques detect residual abnormalities in the majority of patients with seemingly complete mucosal healing by conventional Mayo criteria.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Biopsy

KW - Colitis, Ulcerative

KW - Colon

KW - Colonoscopy

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Intestinal Mucosa

KW - Male

KW - Middle Aged

KW - Reproducibility of Results

KW - Retrospective Studies

KW - Severity of Illness Index

KW - Young Adult

KW - Journal Article

U2 - 10.1055/s-0034-1391863

DO - 10.1055/s-0034-1391863

M3 - Article

C2 - 25826276

VL - 47

SP - 726

EP - 734

JO - Endoscopy

JF - Endoscopy

SN - 0013-726X

IS - 8

ER -