The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Histologic features and predicting prognosis in ulcerative colitis patients with mild endoscopic activity

  • Seung Yong Shin (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Hee Sung Kim (Department of Pathology, Chung-Ang University College of Medicine) ;
  • Kisung Kim (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Chang Won Choi (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Jung Min Moon (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Jeong Wook Kim (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Hyun Jin Joo (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Jeongkuk Seo (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Muhyeon Sung (Department of Internal Medicine, Chung-Ang University College of Medicine) ;
  • Chang Hwan Choi (Department of Internal Medicine, Chung-Ang University College of Medicine)
  • Received : 2023.04.11
  • Accepted : 2023.07.10
  • Published : 2024.01.01
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Abstract

Background/Aims: We aimed to evaluate the histologic features predictive of prognosis and correlate them with endoscopic findings in patients with ulcerative colitis (UC) having complete or partial mucosal healing (MH). Methods: We prospectively collected and reviewed data from patients with UC who underwent colonoscopy or sigmoidoscopy with biopsy. Complete and partial MH were defined as Mayo endoscopic subscores (MESs) of 0 and 1, respectively. Histologic variables, including the Nancy index (NI), predicting disease progression (defined as the need for medication upgrade or hospitalization/surgery), were evaluated and correlated with endoscopic findings. Results: Overall, 441 biopsy specimens were collected from 194 patients. The average follow-up duration was 14.7 ± 7.4 months. There were 49 (25.3%) and 68 (35.1%) patients with MESs of 0 and 1, respectively. Disease progression occurred only in patients with an MES of 1. NI ≥ 3 was significantly correlated with disease progression during follow-up. Mucosal friability on endoscopy was significantly correlated with NI ≥ 3 (61.1% in NI < 3 vs. 88.0% in NI ≥ 3; p = 0.013). Conclusions: Histological activity can help predict the prognosis of patients with UC with mild endoscopic activity. Mucosal friability observed on endoscopy may reflect a more severe histological status, which can be a risk factor for disease progression.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIP [NRF-2020R1F1A1075489]). This research was also supported by the Chung-Ang University Research Grants in 2021.

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