Kanmura Shuji, Hamamoto Hitomi, Tanaka Akihito, Arima Shiho, Sasaki Fumisato, Tanoue Shiroh, Nasu Yuichiro, Hashimoto Shinichi, Higashi Michiyo, Ido Akio
Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Department of Pathology, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Endosc Int Open. 2019 Aug;7(8):E937-E943. doi: 10.1055/a-0810-0398. Epub 2019 Jul 24.
Recent studies recommend histological mucosal healing of intestinal tissue as a treatment goal in ulcerative colitis (UC). Linked-color imaging (LCI) is a new endoscopy system that enhances the color differences of the gastrointestinal mucosa. We investigated the efficacy of LCI in the evaluation of intestinal activity, including the histological activity in UC. A total of 21 UC patients who were evaluated by the LASEREO system (FUJIFILM Co., Tokyo, Japan) were enrolled from August to December in 2016. All of the target points were observed by conventional white-light imaging (WLI) and LCI and biopsied from the region of interest in each view. We quantified the color tones of 73 biopsied points on WLI and LCI using the Lab* color value (WLI-L, WLI-a, WLI-b, and LCI-L, LCI-a, LCI-b). We then investigated the relationships among the Lab* color values, endoscopic findings, and histological healing. The average LCI-a and LCI-b values of patients with high mucosal activity disease were significantly higher than in those with mucosal healing ( < 0.01), and only LCI-a was significantly correlated with the score for histological healing. With regard to the other color values (LCI-L and all WLI values), there were no statistically significant differences in terms of average color value and correlation between patients with high mucosal activity and those with mucosal healing. In addition, the difference in the average color values with LCI and WLI was 7.1 and 3.1, respectively. LCI is more useful than WLI for the visualization and evaluation of mucosal inflammation in UC.
近期研究推荐将肠道组织的组织学黏膜愈合作为溃疡性结肠炎（UC）的治疗目标。联动成像（LCI）是一种新型内镜系统，可增强胃肠道黏膜的颜色差异。我们研究了LCI在评估肠道活动（包括UC的组织学活动）方面的疗效。2016年8月至12月，共纳入21例接受LASEREO系统（日本东京富士胶片公司）评估的UC患者。所有目标点均通过传统白光成像（WLI）和LCI进行观察，并在每个视野的感兴趣区域进行活检。我们使用Lab颜色值（WLI-L、WLI-a、WLI-b以及LCI-L、LCI-a、LCI-b）对73个活检点在WLI和LCI上的色调进行量化。然后，我们研究了Lab颜色值、内镜检查结果和组织学愈合之间的关系。黏膜活动度高的患者的平均LCI-a和LCI-b值显著高于黏膜愈合的患者（<0.01），且只有LCI-a与组织学愈合评分显著相关。对于其他颜色值（LCI-L和所有WLI值），黏膜活动度高的患者与黏膜愈合的患者在平均颜色值和相关性方面无统计学显著差异。此外，LCI和WLI的平均颜色值差异分别为7.1和3.1。在UC中，LCI在可视化和评估黏膜炎症方面比WLI更有用。
