Open Access
CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(04): E568-E575
DOI: 10.1055/a-0869-7619
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Relationship between endoscopic mucosal healing and histologic inflammation during remission maintenance phase in ulcerative colitis: a retrospective study

Mimari Kanazawa
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
,
Fumiaki Takahashi
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
2   Department of Internal Medicine, Japanese Red Cross Ashikaga Hospital, Tochigi, Japan
,
Keiichi Tominaga
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
,
Keiichiro Abe
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
,
Naoya Izawa
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
,
Koh Fukushi
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
,
Kazunori Nagashima
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
,
Akira Kanamori
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
,
Kazuhiro Takenaka
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
,
Takeshi Sugaya
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
,
Makoto Iijima
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
,
Atsuko Takada
3   Department of Diagnostic Pathology, Dokkyo Medical University, Tochigi, Japan
,
Yasuo Imai
3   Department of Diagnostic Pathology, Dokkyo Medical University, Tochigi, Japan
,
Hideyuki Hiraishi
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
,
Atsushi Irisawa
1   Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
› Author Affiliations
Further Information

Publication History

submitted 30 August 2018

accepted after revision 07 February 2019

Publication Date:
04 April 2019 (online)

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Abstract

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.