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( Satoshi Hiyama ),( Hideki Iijima ),( Syoichiro Kawai ),( Akira Mukai ),( Eri Shiraishi ),( Shuko Iwatani ),( Toshio Yamaguchi ),( Manabu Araki ),( Yoshito Hayashi ),( Shinichiro Shinzaki ),( Tsuneka 대한장연구학회 2016 Intestinal Research Vol.14 No.4
Background/Aims: Peyer`s patches (PPs) are aggregates of lymphoid follicles that are mainly located in the distal ileum; they play a major role in mucosal immunity. We recently reported that patients with ulcerative colitis (UC) have alterations in PPs that can be detected using narrow-band imaging with magnifying endoscopy (NBI-ME). However, the usefulness of NBI-ME in UC treatment as a whole is still unknown. Methods: We collected NBI-ME images of PPs from 67 UC patients who had undergone ileocolonoscopy. We evaluated changes in the villi using the “villi index,” which is based on three categories: irregular formation, hyperemia, and altered vascular network pattern. The patients were divided into two groups on the basis of villi index: low (L)- and high (H)-types. We then determined the correlation between morphological alteration of the PPs and various clinical characteristics. In 52 patients who were in clinical remission, we also analyzed the correlation between NBI-ME findings of PPs and clinical recurrence. Results: The time to clinical recurrence was significantly shorter in remissive UC patients with Htype PPs than in those with L-type PPs (P <0.01). Moreover, PP alterations were not correlated with age, sex, disease duration, clinical activity, endoscopic score, or extent of disease involvement. Multivariate analysis revealed that the existence of H-type PPs was an independent risk factor for clinical recurrence (hazard ratio, 3.3; P <0.01). Conclusions: UC patients with morphological alterations in PPs were at high risk of clinical relapse. Therefore, to predict the clinical course of UC, it may be useful to evaluate NBI-ME images of PPs. (Intest Res 2016;14:314-321)