Title: Sa1841 Targeted Biopsies Using Chromoendoscopy Can Replace Random Biopsies in Patients With IBD at High Risk for Colorectal Neoplasia
Abstract: Digital videos were analyzed off-line in a blinded manner for vessel and epithelial morphometry using image processing software.Results To date, 25 subjects have been enrolled, 12 control and 13 cirrhotic patients with documented PHT.Average vessel diameter (AVD) was measured in 249 regions of interest from control vs. 301 regions from subjects with PHT.AVD in controls was 11.4μm (95% CI: 10.5-12.3μm) vs. 17.4μm(95% CI: 15.9-18.9μm) in PHT, p=3.9x10 -7 .In addition, regression analysis revealed a correlation of r=0.77 (95% CI: 0.54-0.89,p=6.4x10 -6 ) between AVD and the severity of portal gastropathy (none, mild, moderate, severe), and revealed a correlation of r=0.79 (95% CI: 0.58-0.9,p=2.4x10 -6 ) between AVD and variceal grade (0-3).The average columnar cell height (ACCH) within the villus epithelial stripe was measured in 219 control vs. 197 PHT regions.ACCH was 39.4μm (95% CI: 33.9-44.9μm) in controls and 52.8μm (95% CI: 48.6-57μm) in PHT, p=3.5x10 -4 .ACCH correlated with the severity of portal gastropathy with r=0.66 (95% CI: 0.35-0.84,p=3.6x10 -4 ), and variceal grade with r=0.5 (95% CI: 0.14-0.75,p=0.01). Conclusion:In the duodenal mucosa, PHT appears to be associated with (1) endoscopicallyinapparent microvascular dilatation and (2) altered epithelial cell volume/morphology revealed In Vivo by pCLE.While PHE has been described endoscopically by congestive vascular features, changes in epithelial morphology (swelling) have not been reported quantitatively to our knowledge.Additional studies will define the correlation between microscopic PHE, vascular patterns, epithelial cell volume, and the hepatic venous pressure gradient.Quantitative pCLE may reveal subclinical PHT and serve as a novel and early biomarker of chronic liver disease and its complications.