Prognosis of ulcerative colitis differs between patients with complete and partial mucosal healing, which can be predicted from the platelet count

Asuka Nakarai, Jun Kato, Sakiko Hiraoka, Toshihiro Inokuchi, Daisuke Takei, Yuki Moritou, Mitsuhiro Akita, Sakuma Takahashi, Keisuke Hori, Keita Harada, Hiroyuki Okada, Kazuhide Yamamoto

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

METHODS: UC patients with sustained clinical remission of 6 mo or more at the time of colonoscopy were examined for clinical outcomes and the hazard ratios of clinical relapse according to MES. Parameters, including blood tests, to identify predictive factors for MES 0 and slight endoscopic recurrence in clinically stable patients were assessed. Moreover, a receiver operating characteristic curve was generated, and the area under the curve was calculated to indicate the utility of the parameters for the division between complete and partial mucosal healing. All P values were two-sided and considered significant when less than 0.05.

AIM: To determine the difference in clinical outcome between ulcerative colitis (UC) patients with Mayo endoscopic subscore (MES) 0 and those with MES 1.

RESULTS: A total of 183 patients with clinical remission were examined. Patients with MES 0 (complete mucosal healing: n = 80, 44%) were much less likely to relapse than those with MES 1 (partial mucosal healing: n = 89, 48%) (P < 0.0001, log-rank test), and the hazard ratio of risk of relapse in patients with MES 1 vs MES 0 was 8.17 (95%CI: 4.19-17.96, P < 0.0001). The platelet count (PLT) < 26 × 10(4)/μL was an independent predictive factor for complete mucosal healing (OR = 4.1, 95%CI: 2.15-7.99). Among patients with MES 0 at the initial colonoscopy, patients of whom colonoscopy findings shifted to MES 1 showed significant increases in PLT compared to those who maintained MES 0 (3.8 × 10(4)/μL vs -0.6 × 10(4)/μL, P < 0.0001).

CONCLUSION: The relapse rate differed greatly between patients with complete and partial mucosal healing. A shift from complete to partial healing in clinically stable UC patients can be predicted by monitoring PLT.

Original languageEnglish
Pages (from-to)18367-18374
Number of pages8
JournalWorld Journal of Gastroenterology
Volume20
Issue number48
DOIs
Publication statusPublished - Dec 28 2014

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Platelet Count
Ulcerative Colitis
Recurrence
Colonoscopy
Hematologic Tests
ROC Curve
Area Under Curve
Odds Ratio

Keywords

  • Mayo endoscopic subscore
  • Mucosal healing
  • Platelet count
  • Ulcerative colitis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Prognosis of ulcerative colitis differs between patients with complete and partial mucosal healing, which can be predicted from the platelet count. / Nakarai, Asuka; Kato, Jun; Hiraoka, Sakiko; Inokuchi, Toshihiro; Takei, Daisuke; Moritou, Yuki; Akita, Mitsuhiro; Takahashi, Sakuma; Hori, Keisuke; Harada, Keita; Okada, Hiroyuki; Yamamoto, Kazuhide.

In: World Journal of Gastroenterology, Vol. 20, No. 48, 28.12.2014, p. 18367-18374.

Research output: Contribution to journalArticle

Nakarai, Asuka ; Kato, Jun ; Hiraoka, Sakiko ; Inokuchi, Toshihiro ; Takei, Daisuke ; Moritou, Yuki ; Akita, Mitsuhiro ; Takahashi, Sakuma ; Hori, Keisuke ; Harada, Keita ; Okada, Hiroyuki ; Yamamoto, Kazuhide. / Prognosis of ulcerative colitis differs between patients with complete and partial mucosal healing, which can be predicted from the platelet count. In: World Journal of Gastroenterology. 2014 ; Vol. 20, No. 48. pp. 18367-18374.
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abstract = "METHODS: UC patients with sustained clinical remission of 6 mo or more at the time of colonoscopy were examined for clinical outcomes and the hazard ratios of clinical relapse according to MES. Parameters, including blood tests, to identify predictive factors for MES 0 and slight endoscopic recurrence in clinically stable patients were assessed. Moreover, a receiver operating characteristic curve was generated, and the area under the curve was calculated to indicate the utility of the parameters for the division between complete and partial mucosal healing. All P values were two-sided and considered significant when less than 0.05.AIM: To determine the difference in clinical outcome between ulcerative colitis (UC) patients with Mayo endoscopic subscore (MES) 0 and those with MES 1.RESULTS: A total of 183 patients with clinical remission were examined. Patients with MES 0 (complete mucosal healing: n = 80, 44{\%}) were much less likely to relapse than those with MES 1 (partial mucosal healing: n = 89, 48{\%}) (P < 0.0001, log-rank test), and the hazard ratio of risk of relapse in patients with MES 1 vs MES 0 was 8.17 (95{\%}CI: 4.19-17.96, P < 0.0001). The platelet count (PLT) < 26 × 10(4)/μL was an independent predictive factor for complete mucosal healing (OR = 4.1, 95{\%}CI: 2.15-7.99). Among patients with MES 0 at the initial colonoscopy, patients of whom colonoscopy findings shifted to MES 1 showed significant increases in PLT compared to those who maintained MES 0 (3.8 × 10(4)/μL vs -0.6 × 10(4)/μL, P < 0.0001).CONCLUSION: The relapse rate differed greatly between patients with complete and partial mucosal healing. A shift from complete to partial healing in clinically stable UC patients can be predicted by monitoring PLT.",
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T1 - Prognosis of ulcerative colitis differs between patients with complete and partial mucosal healing, which can be predicted from the platelet count

AU - Nakarai, Asuka

AU - Kato, Jun

AU - Hiraoka, Sakiko

AU - Inokuchi, Toshihiro

AU - Takei, Daisuke

AU - Moritou, Yuki

AU - Akita, Mitsuhiro

AU - Takahashi, Sakuma

AU - Hori, Keisuke

AU - Harada, Keita

AU - Okada, Hiroyuki

AU - Yamamoto, Kazuhide

PY - 2014/12/28

Y1 - 2014/12/28

N2 - METHODS: UC patients with sustained clinical remission of 6 mo or more at the time of colonoscopy were examined for clinical outcomes and the hazard ratios of clinical relapse according to MES. Parameters, including blood tests, to identify predictive factors for MES 0 and slight endoscopic recurrence in clinically stable patients were assessed. Moreover, a receiver operating characteristic curve was generated, and the area under the curve was calculated to indicate the utility of the parameters for the division between complete and partial mucosal healing. All P values were two-sided and considered significant when less than 0.05.AIM: To determine the difference in clinical outcome between ulcerative colitis (UC) patients with Mayo endoscopic subscore (MES) 0 and those with MES 1.RESULTS: A total of 183 patients with clinical remission were examined. Patients with MES 0 (complete mucosal healing: n = 80, 44%) were much less likely to relapse than those with MES 1 (partial mucosal healing: n = 89, 48%) (P < 0.0001, log-rank test), and the hazard ratio of risk of relapse in patients with MES 1 vs MES 0 was 8.17 (95%CI: 4.19-17.96, P < 0.0001). The platelet count (PLT) < 26 × 10(4)/μL was an independent predictive factor for complete mucosal healing (OR = 4.1, 95%CI: 2.15-7.99). Among patients with MES 0 at the initial colonoscopy, patients of whom colonoscopy findings shifted to MES 1 showed significant increases in PLT compared to those who maintained MES 0 (3.8 × 10(4)/μL vs -0.6 × 10(4)/μL, P < 0.0001).CONCLUSION: The relapse rate differed greatly between patients with complete and partial mucosal healing. A shift from complete to partial healing in clinically stable UC patients can be predicted by monitoring PLT.

AB - METHODS: UC patients with sustained clinical remission of 6 mo or more at the time of colonoscopy were examined for clinical outcomes and the hazard ratios of clinical relapse according to MES. Parameters, including blood tests, to identify predictive factors for MES 0 and slight endoscopic recurrence in clinically stable patients were assessed. Moreover, a receiver operating characteristic curve was generated, and the area under the curve was calculated to indicate the utility of the parameters for the division between complete and partial mucosal healing. All P values were two-sided and considered significant when less than 0.05.AIM: To determine the difference in clinical outcome between ulcerative colitis (UC) patients with Mayo endoscopic subscore (MES) 0 and those with MES 1.RESULTS: A total of 183 patients with clinical remission were examined. Patients with MES 0 (complete mucosal healing: n = 80, 44%) were much less likely to relapse than those with MES 1 (partial mucosal healing: n = 89, 48%) (P < 0.0001, log-rank test), and the hazard ratio of risk of relapse in patients with MES 1 vs MES 0 was 8.17 (95%CI: 4.19-17.96, P < 0.0001). The platelet count (PLT) < 26 × 10(4)/μL was an independent predictive factor for complete mucosal healing (OR = 4.1, 95%CI: 2.15-7.99). Among patients with MES 0 at the initial colonoscopy, patients of whom colonoscopy findings shifted to MES 1 showed significant increases in PLT compared to those who maintained MES 0 (3.8 × 10(4)/μL vs -0.6 × 10(4)/μL, P < 0.0001).CONCLUSION: The relapse rate differed greatly between patients with complete and partial mucosal healing. A shift from complete to partial healing in clinically stable UC patients can be predicted by monitoring PLT.

KW - Mayo endoscopic subscore

KW - Mucosal healing

KW - Platelet count

KW - Ulcerative colitis

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