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Narrow-band imaging with magnifying endoscopy for Peyer's patches is useful in predicting the recurrence of remissive patients with ulcerative colitis.

Authors :
Hiyama S
Iijima H
Kawai S
Mukai A
Shiraishi E
Iwatani S
Yamaguchi T
Araki M
Hayashi Y
Shinzaki S
Mizushima T
Tsujii M
Takehara T
Source :
Intestinal research [Intest Res] 2016 Oct; Vol. 14 (4), pp. 314-321. Date of Electronic Publication: 2016 Oct 17.
Publication Year :
2016

Abstract

Background/aims: Peyer's patches (PPs) are aggregates of lymphoid follicles that are mainly located in the distal ileum; they play a major role in mucosal immunity. We recently reported that patients with ulcerative colitis (UC) have alterations in PPs that can be detected using narrow-band imaging with magnifying endoscopy (NBI-ME). However, the usefulness of NBI-ME in UC treatment as a whole is still unknown.<br />Methods: We collected NBI-ME images of PPs from 67 UC patients who had undergone ileocolonoscopy. We evaluated changes in the villi using the "villi index," which is based on three categories: irregular formation, hyperemia, and altered vascular network pattern. The patients were divided into two groups on the basis of villi index: low (L)- and high (H)-types. We then determined the correlation between morphological alteration of the PPs and various clinical characteristics. In 52 patients who were in clinical remission, we also analyzed the correlation between NBI-ME findings of PPs and clinical recurrence.<br />Results: The time to clinical recurrence was significantly shorter in remissive UC patients with H-type PPs than in those with L-type PPs ( P <0.01). Moreover, PP alterations were not correlated with age, sex, disease duration, clinical activity, endoscopic score, or extent of disease involvement. Multivariate analysis revealed that the existence of H-type PPs was an independent risk factor for clinical recurrence (hazard ratio, 3.3; P <0.01).<br />Conclusions: UC patients with morphological alterations in PPs were at high risk of clinical relapse. Therefore, to predict the clinical course of UC, it may be useful to evaluate NBI-ME images of PPs.<br />Competing Interests: None.

Details

Language :
English
ISSN :
1598-9100
Volume :
14
Issue :
4
Database :
MEDLINE
Journal :
Intestinal research
Publication Type :
Academic Journal
Accession number :
27799882
Full Text :
https://doi.org/10.5217/ir.2016.14.4.314