BACKGROUND Clinical and endoscopic remission are treatment targets in ulcerative colitis (UC). The value of histologic healing in altering clinical outcomes among patients with complete endoscopic healing is not well established. AIM To quantify the association between histologic activity and clinical relapse among patients with UC who were in complete endoscopic remission. METHODS This study included patients with UC from a prospective registry who were in complete endoscopic remission. Histologic activity was quantified by a senior gastrointestinal pathologist. Histologic activity was defined as lack of normalisation (Geboes score > 0) as well as histologically active disease (Geboes score ≥2.1 and ≥3.1). The primary outcome was clinical relapse within 2 years. Multivariable regression adjusting for potential confounders examined the independent predictive value of histologic changes. RESULTS The study included 83 patients (51% women) (median age 44 years; median disease duration 11 years). Forty-one (49%) had complete histologic normalisation. Within two years, 26 (31%) experienced clinical relapse. Patients with complete histologic normalisation were less likely to experience relapse (5/41, 12%) compared to those without normalisation (21/42, 50%, P < 0.001) (multivariable OR 7.22, 95% confidence interval (CI) 2.48-24.70) by the Geboes score. The individual components of the Geboes score predictive of relapse were architectural changes (P = 0.03) and increased chronic inflammatory infiltrate (P < 0.001). CONCLUSIONS Complete histologic healing using the Geboes score was associated with reduced rates of clinical relapse among patients with UC in endoscopic remission.

中文翻译：

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完全的组织学正常化与内镜缓解的溃疡性结肠炎患者复发风险降低有关。

背景技术临床和内窥镜缓解是溃疡性结肠炎（UC）的治疗目标。组织学愈合在改变内镜完全治愈患者的临床结局中的价值尚未得到很好的确定。目的量化完全内镜下缓解的UC患者的组织学活性与临床复发之间的关系。方法该研究纳入了来自前瞻性登记处的UC患者，这些患者处于完全的内镜下缓解状态。组织学活性由高级胃肠病理学家定量。组织学活动被定义为缺乏正常化（Geboes评分> 0）以及组织学活跃的疾病（Geboes评分≥2.1和≥3.1）。主要结果是2年内临床复发。多变量回归调整潜在混杂因素检查了组织学变化的独立预测价值。结果该研究包括83例患者（51％为女性）（中位年龄44岁；中位病程11年）。41名（49％）的组织学已完全正常化。在两年之内，有26位（31％）经历了临床复发。与没有正常化的患者相比，完全组织学正常化的患者发生复发的可能性较小（5 / 41，12％）（21 / 42，50％，P <0.001）（多变量OR 7.22，95％的置信区间（CI）2.48- 24.70）。预测复发的Geboes评分的各个组成部分是结构改变（P = 0.03）和慢性炎症浸润增加（P <0.001）。