Uchiyama K¹, Takagi T¹, etc.

J Crohns Colitis. 2017 Feb 22 Impact factor 6.585

Background and Aims: Mucosal healing and control of intestinal mucosal inflammation are important treatment goals for maintaining clinical remission in ulcerative colitis (UC) patients. Here, we investigated the efficacy of LCI, a novel endoscopic enhancement system, to diagnose mucosal inflammation in UC patients.

Methods: All examinations were carried out with a LASEREO endoscopic system (FUJIFILM Co., Tokyo, Japan). Fifty-two patients with UC were enrolled, and 193 areas assessed by LCI were examined. LCI patterns were classified as A, no redness; B, redness with visible vessels; and C, redness without visible vessels. ROI were set at biopsy sites, and red colour in the ROI was calculated as Commission internationale de l’éclairage (CIE) color space and digitized (LCI-index). Biopsy specimens were taken at each ROI and evaluated with Matts histopathological grade. Thirty months was defined as the time interval between endoscopic diagnosis and relapse of UC.

Results: Inter-observer agreement for LCI classification was excellent between an expert and non-experts. Among areas with a Mayo endoscopic subscore of 0, 41.8% and 4.6% were classified as LCI-B and C respectively. Among areas with Mayo endoscopic subscore of 1, 60.5% and 34.6% were classified as LCI-C, and B respectively. LCI-index strongly correlated with histopathological Matts score. Non-relapse rates significantly correlated with LCI classification (p=0.0055), but not with Mayo endoscopic subscore (p=0.0632).

Conclusions:Endoscopic LCI classification and LCI index can subdivide samples with the same Mayo endoscopic subscore. LCI may be a novel approach to evaluate colonic mucosal inflammation and predict outcome in UC patients.