Quality of ulcer healing in gastrointestinal tract: Its pathophysiology and clinical relevance

Table 1 Definition and criteria of quality of ulcer healing

Definition:

QOUH represents histological maturity of healed peptic ulcer; Evaluation of QOUH should be done to assess functional and endoscopic maturity additionally to histological maturity; For a clinical use an endoscopic evaluation of maturity should be the main method

Criteria:

1: Endoscopic evaluation of maturity

Dye-contrast method, magnified endoscopy, endoscopic ultrasonography

2: Histological maturity

Regenerated mucosa: thickness, width, morphological abnormalities of glands, inflammatory cell infiltration

Granulation tissue: angiogenesis, fibroblasts and fibrosis, regeneration of muscularis mucosae, inflammatory cell infiltration

3: Functional evaluation of maturity

Microcirculation, production of mucin, prostanoids, growth factors, cell proliferation, receptor expression, adhesion molecules

Arakawa et al[12]. QOUH: Quality of ulcer healing.

Table 2 Morphological characteristics of active ulcers in patients with Crohn’s disease reflecting possible future mucosal healing after treatment with infliximab

Morphological finding		Mucosal healing
		Good (n = 10)	Poor (n = 11)	P value1
Shape of ulcer edge	Flat	8	3
	Non-flat	2	8	0.03
Fold convergence	Negative	7	3
	Positive	3	8	0.08
Shape of ulcer base	Flat	4	3
	Non-flat	6	8	0.65
Stenosis	Negative	8	9
	Positive	2	2	0.99
Neighboring ulcer	Negative	9	4
	Positive	1	7	0.02
Width of ulcer	Narrow	9	4
	Wide	1	7	0.02

¹Fisher’s exact test. P value indicates the statistical difference in morphological findings between good and poor mucosal healing.