Department of Gastroenterology, Saint-Louis Hospital, APHP, Université Denis Diderot Paris 7, 75010 Paris, France.
World J Gastroenterol. 2010 Jun 7;16(21):2626-32. doi: 10.3748/wjg.v16.i21.2626.
Endoscopy provides a direct evaluation of mucosal lesions in inflammatory bowel disease (IBD), permitting the description of elementary lesions, their surface extent and severity. The severity of mucosal lesions directly reflects disease activity and may help to identify an aggressive behavior of the disease. Several studies have recently pointed out the potential role of endoscopy in the prediction of IBD outcome. Indeed, severe endoscopic lesions in Crohn's disease (CD) patients, defined by deep and extensive ulcerations on at least one part of the colon, are associated with an increased risk of penetrating complication and surgery. Severe endoscopic lesions during severe attacks of ulcerative colitis (UC) are associated with an increased risk of colectomy in the short and long term. Severity of postoperative recurrence in CD may help to predict the risk of clinical relapse and need for further surgery. Achievement of mucosal healing, which can be obtained by administration of several types of drugs, is associated with a better outcome, less surgery and hospitalization. This review focuses on the assessment of endoscopic severity in CD and UC and on the impact of endoscopic severity on disease outcome. More specifically, we discuss how endoscopy can be used at different stages of IBD to predict the disease course and/or to adapt treatment strategies.
内镜检查为炎症性肠病（IBD）的黏膜病变提供了直接评估，能够描述基本病变、病变表面范围和严重程度。黏膜病变的严重程度直接反映疾病活动度，有助于识别疾病的侵袭性行为。最近的几项研究指出了内镜检查在预测 IBD 结局方面的潜在作用。事实上，克罗恩病（CD）患者内镜下严重病变（定义为结肠至少一个部位存在深而广泛的溃疡）与穿透性并发症和手术风险增加相关。在溃疡性结肠炎（UC）重度发作期间出现严重的内镜下病变与短期和长期内结肠切除术风险增加相关。CD 术后复发的严重程度有助于预测临床复发的风险和进一步手术的需要。通过使用多种类型的药物实现黏膜愈合与更好的结局、更少的手术和住院治疗相关。本综述重点介绍了 CD 和 UC 内镜严重程度的评估以及内镜严重程度对疾病结局的影响。更具体地说，我们讨论了内镜检查如何在 IBD 的不同阶段用于预测疾病过程和/或调整治疗策略。
