Endoscopy 2022; 54(S 01): S16
DOI: 10.1055/s-0042-1744589
Abstracts | ESGE Days 2022
ESGE Days 2022 Oral presentations
1:00–12:00 Thursday, 28 April 2022 Club E. Endoscopic grading and surveillance in IBD

ENDOCYTOSCOPY-BASED IN VIVO GRADING OF INFLAMMATORY ACTIVITY IN ULCERATIVE CORRELATES WITH HISTOLOGY AND CAN PREDICT LONG-TERM DISEASE BEHAVIOUR

F. Vitali
1   University Hospital Erlangen, Department of Medicine, Division of Gastroenterology, Ludwig Demling Endoscopy Center of Excellence, Erlangen, Germany
,
N. Morgenstern
1   University Hospital Erlangen, Department of Medicine, Division of Gastroenterology, Ludwig Demling Endoscopy Center of Excellence, Erlangen, Germany
,
R. Atreya
1   University Hospital Erlangen, Department of Medicine, Division of Gastroenterology, Ludwig Demling Endoscopy Center of Excellence, Erlangen, Germany
,
M. Waldner
1   University Hospital Erlangen, Department of Medicine, Division of Gastroenterology, Ludwig Demling Endoscopy Center of Excellence, Erlangen, Germany
,
A. Hartmann
2   University Hospital Erlangen, Department of Pathology, Erlangen, Germany
,
M.F. Neurath
1   University Hospital Erlangen, Department of Medicine, Division of Gastroenterology, Ludwig Demling Endoscopy Center of Excellence, Erlangen, Germany
,
T. Rath
1   University Hospital Erlangen, Department of Medicine, Division of Gastroenterology, Ludwig Demling Endoscopy Center of Excellence, Erlangen, Germany
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Aims Increasing evidence suggests that not only mucosal healing, but also histologic healing could be an essential prognostic parameter in patients with inflammatory bowel diseases (IBD). Within this study, we aimed to evaluate whether endocytoscopy as a new technique enabling in vivo histology can accurately assess histologic inflammation in IBD patients and predict long-term disease outcome.

Methods 46 consecutively enrolled patients with ulcerative colitis (UC) were included. The in vivo assessment of histologic inflammation was made with a commercially available endocytoscope (Olympus CF-H290ECI, Olympus, Japan). In vivo microscopic inflammatory activity during endocytoscopy was scored by four independent endoscopists using a novel endocytoscopy score (ELECT, ErLangen Endocystoscopy for ColiTis). Targeted biopsies of the imaged areas were obtained and results were compared against two validated histopathological scores in UC (Robarts Histopathology Index, RHI; Nancy Histology Index, NHI). Moreover, interobserver agreement and performance of endocytoscopy-based grading of inflammatory activity for predicting long-term disease outcome were calculated

Results A new and intuitive endocytoscopy score was developed as a consensus between experts in optical diagnosis in IBD patients. During subsequent validation, endocytoscopic grading of inflammatory activity in UC based on the ELECT score showed strong correlation with histopathological scoring (RHI: r=0.70, NHI: r=0.73) with high diagnostic accuracy and sensitivity. Interobserver agreement for endocytoscopic remission between four endoscopists was 0.801. An ELECT score≤2 was a prognostic marker for favorable clinical and endoscopic disease outcome during 15 months follow-up.

Conclusions Endocytoscopy enables accurate real-time assessment of histologic inflammation and can predict long-term disease behavior in UC.



Publication History

Article published online:
14 April 2022

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