P254 The significance of LCI Index of rectal mucosa of the patients of ulcerative colitis. (16th January 2018)

• Record Type: Journal Article
• Authors: Uchiyama, K; Takagi, T; Kashiwagi, S; Toyokawa, Y; Yagi, N; Naito, Y; Itoh, Y
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S228
• Page End: S229
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.381
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: It has not been established the endoscopic evaluation for the patients of ulcerative colitis (UC). Although the patients with mucosal healing diagnosed as Mayo endoscopic subscore (MES) 0, some patients showed relapse. Therefore, new endoscopic evaluation is needed to diagnose the mucosal healing of UC patients to predict the prognosis objectively. We have already reported the effectiveness of new endoscopic imaging system: LCI (Linked Color Imaging) to diagnose the mucosal healing of UC patients [1] . LCI Index is the objective parameter which digitise mucosal redness based on LCI image. In this study, we investigated the usefulness of the LCI Index to diagnose the mucosal healing with rectal mucosa. Methods: All examinations were carried out with an EG-L590WR endoscope and a LASEREO endoscopic system (FUJIFILM Co., Tokyo, Japan) including 50 UC patients with clinically remission (Under 4 of Lichtiger CAI score). The reddest area of rectum (Ra) was evaluated by LCI and diagnosed by endoscopic LCI classification (LCI-A, -B, -C) [1] . Inflammation in the biopsy specimen was evaluated according to the four phases of Matts' biopsy specimen classification. The ROI (40 × 40 pixels) was set at the location of the biopsy, and the red colour in the ROI was digitised as LCI Index. TNF- α mRNA expression was measured at the point of ROI as well. The patients were observed for 3 years at longest. Results: No relapse was observed in the group with LCI-A ( n = 13). The relapse rate of LCI-B, and -C was 34.5% (10/29) and 85.7% (6/7). The average of LCI Index with relapse group was statistically higher (37.30) compared with the average of non-relapse group (22.52). The Matts grade 3 of biopsy specimens were diagnosed as 50.0% of relapse group and 41.6% of non-relapse group respectively. There is no difference of mucosal TNF- α expression between relapse group and non-relapse group and no correlation between TNF- α and LCI Index. Conclusions: The LCI classification and LCI Index of rectal mucosa of UC patients is considered as a practical approach to predict the prognosis of UC patients. However, rectal mucosal inflammation such as inflammatory cell infiltration and TNF- α expression were not related to the prognosis of UC. References: 1. Uchiyama K, Takagi T, Kashiwagi S, et al. Assessment of endoscopic mucosal healing of ulcerative colitis using linked colour imaging, a novel endoscopic enhancement system. J Crohns Colitis, 2017;11:963–9.