Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2022; 10(15): 4818-4826
Published online May 26, 2022. doi: 10.12998/wjcc.v10.i15.4818
Endoscopic ultrasonography in the evaluation of condition and prognosis of ulcerative colitis
Rui-Fang Jin, Yi-Man Chen, Ren-Pin Chen, Hua-Jun Ye
Rui-Fang Jin, Yi-Man Chen, Ren-Pin Chen, Hua-Jun Ye, Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Author contributions: Jin RF and Ye HJ designed this retrospective study; Jin RF wrote the manuscript; Jin RF, Chen YM, Chen PP and Ye HJ sorted the data; all author read and confirmed the revised manuscript.
Supported by Wenzhou Science and Technology Bureau, No. Y2020296.
Institutional review board statement: The study was approved by the Ethics Committee of The First Affiliated Hospital of Wenzhou Medical University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors have nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hua-Jun Ye, MM, Doctor, Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Nanbai Elephant Street, Ouhai District, Wenzhou 325000, Zhejiang Province, China. ye173401298@163.com
Received: January 6, 2022
Peer-review started: January 6, 2022
First decision: February 7, 2022
Revised: February 17, 2022
Accepted: March 26, 2022
Article in press: March 26, 2022
Published online: May 26, 2022
Abstract
BACKGROUND

Ulcerative colitis (UC) is usually diagnosed through histopathology, enteroscopy, clinical symptoms, and physical findings; however, it is difficult to accurately evaluate disease severity.

AIM

To investigate the value of endoscopic ultrasonography (EUS) in the evaluation of the severity and prognosis of UC.

METHODS

Patients with UC who were seen in our hospital from March 2019 to December 2020 were eligible, and disease severity was evaluated according to the modified Truelove and Witts and Mayo scores. We performed EUS, calculated the UC endoscopic index of severity (UCEIS) and EUS-UC scores, and administered appropriate treatment. The UCEIS and EUS-UC scores of patients were assessed in relation to disease severity, and the correlations between UCEIS and EUS-UC scores and disease severity was also analyzed. The UCEIS and EUS-UC scores before and after treatment were also compared.

RESULTS

A total of 79 patients were included in this study. According to the Mayo Index, 23, 32, and 24 patients had mild, moderate and severe UC, respectively. The UCEIS and EUS-UC scores were higher in moderate cases (4.98 ± 1.04 and 5.01 ± 0.99, respectively) than in mild cases (1.56 ± 0.82 and 1.64 ± 0.91, respectively, P < 0.05). Furthermore, the UCEIS and EUS-UC scores (7.31 ± 1.10 and 7.59 ± 1.02, respectively) were higher in severe cases than in moderate cases (P < 0.05). According to the modified Truelove and Witts scores, 21, 36, and 22 patients were classified as having mild, moderate and severe disease, respectively. The UCEIS and EUS-UC scores were significantly higher in moderate disease (4.79 ± 1.11 and 4.96 ± 1.23, respectively) than in mild disease (1.71 ± 0.78 and 1.69 ± 0.88, respectively, P < 0.05). Additionally, the UCEIS and EUS-UC scores in severe disease (7.68 ± 1.22 and 7.81 ± 0.90, respectively) were significantly higher than in moderate disease (P < 0.05). The UCEIS and EUS-UC scores were significantly and positively correlated with disease severity according to the modified Truelove and Witts score and Mayo score (P < 0.05). The UCEIS and EUS-UC scores after 2 mo of treatment (3.88 ± 0.95 and 4.01 ± 1.14, respectively) and after 6 mo of treatment (1.59 ± 0.63 and 1.64 ± 0.59, respectively) were lower than the respective scores before treatment (5.93 ± 1.79 and 6.04 ± 2.01) (P < 0.05).

CONCLUSION

EUS can clarify the status of UC and accurately evaluate the treatment response, providing an objective basis for formulation and adjustment of the treatment plan.

Keywords: Endoscopic ultrasonography, Ulcerative colitis, Disease severity, Prognosis, Ulcerative colitis endoscopic index of severity score, Endoscopic ultrasonography-ulcerative colitis score, Mayo disease activity index

Core Tip: Endoscopic ultrasonography can effectively clarify the status of patients with ulcerative colitis, stratify the disease severity, and accurately evaluate the treatment response to provide an objective basis for clinical formulation or further adjustment of the treatment plan.