Clinical relevance of endoscopic assessment of inflammation in ulcerative colitis: Can endoscopic evaluation predict outcomes?

Table 4 Correlation between white light endoscopy and histology in ulcerative colitis

Ref.	Study characteristics and aims	Results
Bitton et al[8]	Prospective observational study	36.4% patients relapsed
2001	74 patients in clinical and endoscopic remission were included	Younger age, multiple previous relapses (women), and basal plasmacytosis on histology predicted relapse.
United States	Followed up for a year or until the patients relapsed.	CRP, ESR, IL-1b, -6, 15, ANCA was non-predictive of relapse.
Azad et al[41]	Prospective observational study	57.7% patients relapsed
2011	26 patients with clinical and endoscopic remission were included	Increased Eosinophils and Neutrophils were predictors of relapse.
India	Monthly follow up for a year or until the patients relapsed.	Hb, CRP, ESR, IL-6 were not predictive of relapse.
Bessissow et al[7]	Retrospective study	Microscopic inflammation was found in 40% of patients.
2012	75 patients with endoscopically inactive disease (Mayo score 0)	Basal plasmacytosis and histological activity (Geboes score ≥ 3.1) predicted relapse.
Belgium	Time to relapse was noted
Lemmens et al[40]	Retrospective study	Significant correlation with Mayo endoscopic subscore and histology noted in extremes of disease (inactive and acute severe disease)
2013	131 patients with known UC
Belgium	Correlation of endoscopy and histology
Rosenberg et al[5]	Prospective observational study	54% of patients with quiescent disease had signs of histological inflammation.
2013	103 UC patients in clinical remission
United States	Correlation of endoscopy and histology
Feagins et al[6]	Retrospective study of 51 patients.	20% of patients had flare up within 12 mo.
2013	colonoscopy for surveillance	Basal lymphocytosis, disruption of crypt architecture, erosions and ulcers predicted relapse.
United States	Correlation of endoscopic and histological activity
Zenlea et al[42]	Prospective study	23% of patients relapsed
2016	179 patients included	Histological activity with Geboes score ≥ 3.1 was strongest predictor of relapse.
United States	Baseline Mayo endoscopic score and Geboes score for histology noted
	Follow up period was 12 mo

UC: Ulcerative colitis; Hb: Haemoglobin; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; IL-6: Interleukin-6; ANCA: Anti-nutrophil cytoplasmic antibody.