Histological Markers of Clinical Relapse in Endoscopically Quiescent Ulcerative Colitis
| Autor: | Callum Dargavel, David Kevans, Mark S. Silverberg, Richard Kirsch, Boyko Kabakchiev, Robert H. Riddell |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Colon Biopsy Plasma Cells Colonoscopy Severity of Illness Index Gastroenterology Basal (phylogenetics) Clinical Research Recurrence Internal medicine medicine Humans Immunology and Allergy Intestinal Mucosa Prospective cohort study Wound Healing medicine.diagnostic_test Histocytochemistry business.industry Remission Induction Plasmacytosis Mucous membrane Histology medicine.disease Ulcerative colitis medicine.anatomical_structure Colitis Ulcerative Female business Biomarkers Index Colonoscopy |
| Zdroj: | Inflamm Bowel Dis |
| ISSN: | 1536-4844 1078-0998 |
| Popis: | Background In ulcerative colitis (UC) patients who have achieved mucosal healing, active microscopic colonic mucosal inflammation is commonly observed. We aimed to assess the association between histological activity and disease relapse in endoscopically quiescent UC. Methods Ulcerative colitis patients with endoscopically quiescent disease and ≥12 months of follow-up were included. Biopsies were reviewed for the presence of basal plasmacytosis (BPC) and active histological inflammation, defined as a Geboes score (GS) ≥3.2. Primary outcome measures were disease relapse at 18 months and time to first relapse after index colonoscopy. Results Seventy-six UC patients (51% male; mean age, 38.6 years; median follow-up [range], 75.2 [2–118] months) were included. Sixty-two percent had an endoscopic Mayo score of 0 at index colonoscopy. Basal plasmacytosis was present in 46% and active histological inflammation in 30% of subjects. Presence of BPC was associated with a significantly shorter time to disease relapse (P = 0.01). Active histological inflammation was significantly associated with clinical relapse at 18 months (P = 0.0005) and shorter time to clinical relapse (P = 0.0006). Multivariate analysis demonstrated active histological inflammation to be independently associated with clinical relapse at 18 months and time to clinical relapse. Conclusions In endoscopically quiescent UC, active histological inflammation and the presence of BPC are adjunctive histological markers associated with increased likelihood of disease relapse. Although prospective studies are required, the presence of these histological markers should be a factor considered when making therapeutic decisions in UC. |
| Databáze: | OpenAIRE |
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