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P121 Correlation between histological activity and endoscopy in patients with UC, seen in a tertiary centre of gastroenterology in Romania

M. Cojocaru*1, C. Gheorghe2, L. Gheorghe2

1Center for Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Gastroenterology, Bucharest, Romania, 2Center for Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania

Background

Histological activity is important in the choice of drug treatment and the patients with residual microscopic acute inflammation are more likely to relapse. The aim of this study was to see if there is any correlation between the macroscopic aspect of the colon and the degree of histological activity in patients with ulcerative colitis.

Methods

The medical charts of a total 84 patients were reviewed with a median age of 39.8 years old (18–78 years); 55 of them were males and 29 were females, most of them from the urban area/ non-smokers and 154 biopsies were analysed by a histopathologist with experience in IBD. Colonoscopies or sigmoidoscopies with biopsies were performed once in 65 patients, twice in 11 patients, three times in 4 patients, and four times in 3 patients. Total number of endoscopies performed are 102. To make a difference between histologically active or inactive disease, we considered a Geboes score >3.1 and regarding endoscopy, the optimal cut-off Mayo endoscopic subscore to be a score of 1. Extent of disease: E1–28 (22%); E2–33 (40%); E3–31 (38%).

Results

In 61% of all endoscopies, the mucosa was inflamed, but anyway 15% did not show an important histological inflammation (Geboes score <3.1). Endoscopic remission was observed in the other 35.4% of procedures; however, in biopsies, 22% exhibited histological inflammation.

Conclusion

Our results indicate that histological activity was correlated with endoscopic activity in patients with UC. Focal active inflammation is likely to be missed by endoscopy and biopsies thus add an additional dimension regarding the presence of inflammation. Therefore, it seems appropriate to use both endoscopy and histology for the assessment of disease activity and extent.