Beyond complete endoscopic healing: Goblet appearance using an endocytoscope to predict future sustained clinical remission in ulcerative colitis.
histologic remission
microscopic endoscopy
treat to target
ulcerative colitis
Journal
Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
ISSN: 1443-1661
Titre abrégé: Dig Endosc
Pays: Australia
ID NLM: 9101419
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
revised:
09
11
2021
received:
06
09
2021
accepted:
21
11
2021
pubmed:
25
11
2021
medline:
7
7
2022
entrez:
24
11
2021
Statut:
ppublish
Résumé
Complete endoscopic healing, defined as Mayo endoscopic score (MES) = 0, is an optimal target in the treatment of ulcerative colitis (UC). However, some patients with MES = 0 show clinical relapse within 12 months. Histologic goblet mucin depletion has emerged as a predictor of clinical relapse in patients with MES = 0. We observed goblet depletion in vivo using an endocytoscope, and analyzed the association between goblet appearance and future prognosis in UC patients. In this retrospective cohort study, all enrolled UC patients had MES = 0 and confirmed clinical remission between October 2016 and March 2020. We classified the patients into two groups according to the goblet appearance status: preserved-goblet and depleted-goblet groups. We followed the patients until March 2021 and evaluated the difference in cumulative clinical relapse rates between the two groups. We identified 125 patients with MES = 0 as the study subjects. Five patients were subsequently excluded. Thus, we analyzed the data for 120 patients, of whom 39 were classified as the preserved-goblet group and 81 as the depleted-goblet group. The patients were followed-up for a median of 549 days. During follow-up, the depleted-goblet group had a significantly higher cumulative clinical relapse rate than the preserved-goblet group (19% [15/81] vs. 5% [2/39], respectively; P = 0.02). Observing goblet appearance in vivo allowed us to better predict the future prognosis of UC patients with MES = 0. This approach may assist clinicians with onsite decision-making regarding treatment interventions without a biopsy.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1030-1039Subventions
Organisme : Japan Society for the Promotion of Science KAKENHI
ID : JP 17K15973
Organisme : Japan Society for the Promotion of Science KAKENHI
ID : JP20K17002
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021 Japan Gastroenterological Endoscopy Society.
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