Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
J Crohns Colitis. 2017 Aug 1;11(8):963-969. doi: 10.1093/ecco-jcc/jjx026.
Mucosal healing and control of intestinal mucosal inflammation are important treatment goals for maintaining clinical remission in ulcerative colitis [UC] patients. Here, we investigated the efficacy of linked colour imaging [LCI], a novel endoscopic enhancement system, for diagnosing mucosal inflammation in UC patients.
All examinations were carried out with a LASEREO endoscopic system [FUJIFILM Co., Tokyo, Japan]. Fifty-two patients with UC were enrolled, and 193 areas assessed by LCI were examined. LCI patterns were classified as; A, no redness; B, redness with visible vessels; and C, redness without visible vessels. Regions of interest [ROIs] were set at biopsy sites, and the red colour in the ROI was calculated from the Commission internationale de l'éclairage [CIE] color space and digitized [LCI-index]. Biopsy specimens were taken at each ROI and evaluated with Matts histopathological grade. Thirty months was defined as the time interval between endoscopic diagnosis and relapse of UC.
Interobserver agreement for LCI classification was excellent between an expert and non-experts. Among areas with a Mayo endoscopic subscore of 0, 41.8% and 4.6% were classified as LCI-B and LCI-C, respectively. Among areas with a Mayo endoscopic subscore of 1, 60.5% and 34.6% were classified as LCI-C and LCI-B, respectively. The LCI index strongly correlated with the histopathological Matts score. Non-relapse rates significantly correlated with LCI classification [p = 0.0055], but not with Mayo endoscopic subscore [p = 0.0632].
Endoscopic LCI classification and LCI index can subdivide samples with the same Mayo endoscopic subscore. LCI may be a novel approach for evaluating colonic mucosal inflammation and for predicting outcome in UC patients.
黏膜愈合和控制肠道黏膜炎症是溃疡性结肠炎[UC]患者维持临床缓解的重要治疗目标。在这里，我们研究了新型内镜增强系统——联合色彩成像[LCI]诊断 UC 患者黏膜炎症的疗效。
所有检查均采用 LASEREO 内镜系统[FUJIFILM Co.，东京，日本]进行。共纳入 52 例 UC 患者，共检查 193 个 LCI 评估区域。LCI 模式分为：A，无红斑；B，红斑伴可见血管；C，红斑无可见血管。在活检部位设置感兴趣区域[ROI]，并从国际照明委员会[CIE]颜色空间和数字化[LCI 指数]中计算 ROI 中的红色。在每个 ROI 处进行活检，并采用 Matts 组织病理学评分进行评估。内镜诊断与 UC 复发之间的时间间隔定义为 30 个月。
专家和非专家之间的 LCI 分类观察者间一致性极好。Mayo 内镜亚评分 0 的区域中，分别有 41.8%和 4.6%被分类为 LCI-B 和 LCI-C。Mayo 内镜亚评分 1 的区域中，分别有 60.5%和 34.6%被分类为 LCI-C 和 LCI-B。LCI 指数与组织病理学 Matts 评分呈强相关性。无复发率与 LCI 分类显著相关[p=0.0055]，但与 Mayo 内镜亚评分无关[p=0.0632]。
内镜 LCI 分类和 LCI 指数可细分具有相同 Mayo 内镜亚评分的样本。LCI 可能是评估结直肠黏膜炎症和预测 UC 患者结局的一种新方法。
