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P215 Correlation of histological activity and basal plasmacytosis with mucosal healing in ulcerative colitis patients

K. Farkas*1, Z. Reisz2, A. Sejben2, L. Tiszlavicz2, M. Szücs3, Z. Szepes1, F. Nagy1, M. Rutka1, A. Bálint1, R. Bor1, Á. Milassin1, T. Molnár1

1University of Szeged, 1st Department of Medicine, Szeged, Hungary, 2University of Szeged, Department of Pathology, Szeged, Hungary, 3University of Szeged, Department of Medical Physics and Informatics, Szeged, Hungary

Background

Microscopic activity in ulcerative colitis (UC) patients with endoscopic remission is becoming more and more important in the prediction of relapse. The presence of basal plasmacytosis and the increased number of eosinophils and neutrophils in the lamina propria have been supposed to predict clinical relapse in UC patients with complete mucosal healing. The aim of this study was to examine the correlation between the microscopic activity and the disease outcome in patients with endoscopically inactive UC.

Methods

Sixty-nine UC patients (mean age at diagnosis was 31.4 years, male/female ratio: 27/42) with endoscopic remission (eMayo 0 and 1) and at least 12-month follow-up between 2008 and 2013 were enrolled in this prospective observational study. An expert pathologist evaluated all colonic biopsies for histologic activity (Geboes score) and the presence of basal plasmacytosis. C-reactive protein (CRP), partial Mayo scores and the used medications were documented at the time of the endoscopy, and the follow-up appointments: at months 6, 12 and 24 and at the last visit. Disease relapse was defined as a partial Mayo score equal or more than 3.

Results

Histology revealed focal or diffuse basal plasmacytosis and microscopic inflammatory activity with a Geboes score equal or more than 3.1 in 81.2% and 37.7% of patients with mucosal healing. At 6, 12 and 24 months and at the follow up visit, clinical relapsed occurred in 19%, in 14.5%, in 13%, and in 16% of the patients. The mean time of follow-up was 3 years. Neither of the presence of basal plasmacytosis, nor Geboes score equal or more than 3.1 was predictive of disease relapse at 6, 12, 24 months and at follow-up. No difference was observed if the data were analyzed separately in subgroups of eMayo score of 0 or 1.

Conclusion

Our Results did not confirm the previous hypothesis that the presence of basal plasmacytosis and microscopic inflammation predicts UC clinical relapse in patients with mucosal healing.