ABSTRACT
Objective:To investigate the predictive value of mucosal vascular pattern (MVP) under narrow-band imaging (NBI) enteroscopy in patients with ulcerative colitis (UC) in clinical remission for histological healing and clinical recurrence.Methods:A total of 142 patients with UC in clinical remission who visited the First Affiliated Hospital of Weifang Medical University from January 2018 to January 2021 were included in the study and underwent colonoscopy. The white light and NBI endoscopic images were collected and biopsies were obtained. The Mayo endoscopic score (MES) was calculated based on white light images, and MVP staging was evaluated based on mucosal vascular patterns under NBI. Nancy index (NI) was used to evaluate histological healing and patients were followed up for 1 year. The Spearman correlation coefficients of MES and MVP with histological healing and recurrence were calculated. The receiver operator characteristic (ROC) curve was plotted and the area under curve (AUC) was applied to evaluate the accuracy of white light and NBI endoscopy for predicting histological healing of UC in clinical remission.Results:According to the MVP criteria, 47 were defined as clear, 63 blurred, and 32 invisible. Spearman correlation analysis showed a significant correlation between MVP under NBI and histological healing ( r=0.549, P<0.001) and a moderate correlation between MES under white light and histological healing ( r=0.462, P<0.001). Spearman correlation analysis showed a moderate correlation between MVP under NBI and clinical recurrence ( r=0.451, P<0.001) and a moderate correlation between MES under white light and clinical recurrence ( r=0.352, P<0.001). AUC of NBI for diagnosing histological healing of UC in clinical remission was 0.809 (95% CI: 0.738-0.879), with a sensitivity of 84.6% (77/91) and specificity of 64.7% (33/51), superior to the white light endoscopy, of which AUC, sensitivity and specificity were 0.763 (95% CI: 0.678-0.848), 81.3% (74/91) and 66.7% (34/51). Conclusion:MVP staging under NBI could predict histological healing of UC patients in clinical remission and is superior to white light endoscopy.
ABSTRACT
Background:Reduction of incidence and recurrence rates of colorectal adenoma (CRA)are the keys for reducing the incidence of colorectal cancer. Studies have shown that insulin resistance is involved in this process. Aims:To investigate the correlation of insulin resistance with incidence and recurrence of CRA. Methods:Clinical data of 238 CRA patients were collected,and 200 patients with normal colonoscopy results were served as controls. Waist to hip ratio (WHR), fasting blood glucose (FPG),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C),adiponectin,fasting insulin (FINS),HOMA-IR were compared between the two groups. Correlation of insulin resistance with incidence and recurrence of CRA was analyzed. Results:WHR,FPG, TG,FINS,adiponectin and HOMA-IR were statistically different between CRA group and controls (P＜0.05),however, no significant differences in BMI,DBP,TC,HDL-C,LDL-C were found between the two groups. Incidence rate of CRA (80.1% vs. 41.4%)and recurrence rate of CRA (62.4% vs. 46.3%)were significantly increased in patients with insulin resistance than those in patients without insulin resistance. Logistic regression analysis showed that family history, metabolic syndrome and HOMA-IR were independent risk factors for incidence of CRA (P ＜0. 05 ),and metabolic syndrome,family history of adenoma,adenoma number,adenoma size,pathological type and HOMA-IR were independent risk factors for recurrence of CRA (P＜0.05). Conclusions:The incidence and recurrence rates of CRA are higher in patients with insulin resistance than those without insulin resistance.