Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
Int J Colorectal Dis. 2021 May;36(5):1053-1061. doi: 10.1007/s00384-020-03810-9. Epub 2021 Jan 7.
In the treatment of ulcerative colitis (UC), accurate evaluation of UC activity is important to achieve mucosal healing. We sought to investigate the clinical utility of linked color imaging (LCI) for the evaluation of endoscopic activity and prediction of relapse in UC patients.
We enrolled 72 consecutive UC patients in remission who underwent colonoscopy at our institution between September 2016 and October 2018. The relationship between the presence of redness in white light imaging (WLI) and LCI and histopathological inflammation (Geboes score: GS) at 238 biopsy sites was examined. We also assessed the presence or absence of planar redness in the entire rectum as ± and classified the patients into three groups according to the combination of WLI/LCI: A: WLI-/LCI-, B: WLI-/LCI+, and C: WLI+/LCI+. The relationship between WLI/LCI classification and relapse in 64 patients followed up for more than 12 months from initial colonoscopy was assessed and compared to the Mayo endoscopic subscore (MES).
A GS of 0 or 1 accounted for 89% of WLI/LCI non-redness sites, while a GS of 2 or 3 accounted for 42% of WLI non-redness/LCI redness sites. LCI findings were significantly correlated with GS. During follow-up, 10 patients in group C and four patients in group B relapsed, but none in group A. Non-relapse rates were significantly correlated with WLI/LCI classification, but not with MES.
LCI is a useful modality for accurate assessment of endoscopic activity and prediction of relapse in UC by detecting mild inflammation unrecognizable by WLI.
在溃疡性结肠炎（UC）的治疗中，准确评估 UC 的活动对于实现黏膜愈合很重要。我们旨在研究链接色彩成像（LCI）在评估 UC 患者内镜活动和预测复发中的临床应用价值。
我们纳入了 2016 年 9 月至 2018 年 10 月在我院接受结肠镜检查的 72 例缓解期 UC 患者。研究考察了白光成像（WLI）和 LCI 中红色与组织病理学炎症（Geboes 评分：GS）在 238 个活检部位的关系。我们还评估了整个直肠是否存在平面红色（±），并根据 WLI/LCI 的组合将患者分为三组：A：WLI-/LCI-，B：WLI-/LCI+，和 C：WLI+/LCI+。评估了 64 例在初始结肠镜检查后随访超过 12 个月的患者的 WLI/LCI 分类与复发的关系，并与 Mayo 内镜亚评分（MES）进行了比较。
GS 为 0 或 1 的患者占 WLI/LCI 非红色部位的 89%，而 GS 为 2 或 3 的患者占 WLI 非红色/LCI 红色部位的 42%。LCI 结果与 GS 显著相关。在随访期间，C 组中有 10 例和 B 组中有 4 例患者复发，但 A 组中无一例患者复发。无复发率与 WLI/LCI 分类显著相关，但与 MES 无关。
LCI 通过检测 WLI 无法识别的轻度炎症，是一种用于准确评估 UC 内镜活动和预测复发的有用方法。
