Minute findings by magnifying colonoscopy are useful for the evaluation of ulcerative colitis.

Abstract:

BACKGROUND:Colonoscopy has an important role in the diagnosis of ulcerative colitis. However, colonoscopic findings are inadequate for the prediction of relapse without histologic examination. In this study, the role of magnifying colonoscopy in ulcerative colitis was evaluated. METHODS:One hundred sixteen magnifying colonoscopy observations were made in 61 patients with ulcerative colitis between January 1994 and October 1998. A simple classification of magnifying colonoscopic findings into 5 categories was devised as follows: regularly arranged crypt openings, villous-like, minute defects of epithelium, small yellowish spots, and coral reef-like appearance. The colonoscopic findings by classification were compared with histopathologic findings, and the usefulness of the classification for predicting relapse was prospectively analyzed in 18 patients. RESULTS:Compared with grade as determined by conventional colonoscopy, there was a better correlation between the classification of findings by magnifying colonoscopy and histopathologic findings (r(2) = 0.665, 0.807, respectively). Of 18 patients studied prospectively, 7 of 9 with minute defects of epithelium relapsed within 6 months, and the cumulative nonrelapsing rate was significantly lower in patients with minute defects of epithelium compared with those without minute defects of epithelium (p = 0.0059). Moreover, minute defects of epithelium was found to be a significant independent predictive factor for relapse (multivariate analysis, Cox proportional hazards model; p = 0.0203). CONCLUSIONS:Our proposed classification of magnifying colonoscopic findings in patients with ulcerative colitis is useful for the evaluation of disease activity and for the prediction of periods of remission.

journal_name

Gastrointest Endosc

authors

Fujiya M,Saitoh Y,Nomura M,Maemoto A,Fujiya K,Watari J,Ashida T,Ayabe T,Obara T,Kohgo Y

doi

10.1067/mge.2002.127101

keywords:

subject

Has Abstract

pub_date

2002-10-01 00:00:00

pages

535-42

issue

4

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(02)70439-2

journal_volume

56

pub_type

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