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Assessment of Histologic Disease Activity in Evaluation of Endoscopic Severity of Ulcerative Colitis : From a Stand-point of Assessment of Biopsy Specimens Yoichi Ajioka 1 , Junji Yokoyama 2 , Terasu Honma 3 1Division of Molecular and Diagnostic Pathology, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan 2Division of Gastrointestinal Gastroenterology and Hepatology, Niigata University, Graduate School of Medical and Dental Sciences, Niigata, Japan 3Department of Gastroenterology, Saiseikai Niigata Daini Hospital, Niigata, Japan Keyword: 潰瘍性大腸炎 , 生検組織 , 炎症活動性評価 , 難治化予測 , 内視鏡的重症度 , IBD pp.148-156
Published Date 2018/2/25
DOI https://doi.org/10.11477/mf.1403201276
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 HDAs(histologic disease activities)were assessed and compared between 39 cases of non-refractory and 32 cases of refractory ulcerative colitis with severe endoscopic findings. Matts histologic grading of biopsy specimen(Matts grade)and histologic activity score comprising 9 parameters, modified by Riley and Geboes histologic scores, were used for HDA assessment. Refractory cases showed higher Matts grade than non-refractory cases, and a frequency of Grade 5 of the former was significantly higher than that of the latter(84.4% vs. 59.0%). Average HAS was significantly higher for refractory cases than non-refractory cases(19.3±3.4 vs. 15.9±4.1). For each histologic parameter, neutrophil infiltration and surface epithelium integrity score were significantly higher for refractory cases than non-refractory cases. Furthermore, cases with the neutrophil infiltration score higher than eosinophilia score were more frequent for refractory cases than non-refractory cases. This finding indicates that even if the endoscopic findings are equal, HDA is not identical, and the assessment of HDA using biopsy specimens is useful to re-evaluate endoscopic severity.


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