Limited validity of Mayo endoscopic subscore in ulcerative colitis with concomitant primary sclerosing cholangitis.

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY

World Journal of Gastrointestinal Endoscopy Pub Date : 2024-11-16 DOI:10.4253/wjge.v16.i11.607

Pavel Wohl, Alzbeta Krausova, Petr Wohl, Ondrej Fabian, Lukas Bajer, Jan Brezina, Pavel Drastich, Mojmir Hlavaty, Petra Novotna, Michal Kahle, Julius Spicak, Martin Gregor

{"title":"Limited validity of Mayo endoscopic subscore in ulcerative colitis with concomitant primary sclerosing cholangitis.","authors":"Pavel Wohl, Alzbeta Krausova, Petr Wohl, Ondrej Fabian, Lukas Bajer, Jan Brezina, Pavel Drastich, Mojmir Hlavaty, Petra Novotna, Michal Kahle, Julius Spicak, Martin Gregor","doi":"10.4253/wjge.v16.i11.607","DOIUrl":null,"url":null,"abstract":"Background: Ulcerative colitis (UC) with concomitant primary sclerosing cholangitis (PSC) represents a distinct disease entity (PSC-UC). Mayo endoscopic subscore (MES) is a standard tool for assessing disease activity in UC but its relevance in PSC-UC remains unclear.Aim: To assess the accuracy of MES in UC and PSC-UC patients, we performed histological scoring using Nancy histological index (NHI).Methods: MES was assessed in 30 PSC-UC and 29 UC adult patients during endoscopy. NHI and inflammation were evaluated in biopsies from the cecum, rectum, and terminal ileum. In addition, perinuclear anti-neutrophil cytoplasmic antibodies, fecal calprotectin, body mass index, and other relevant clinical characteristics were collected.Results: The median MES and NHI were similar for UC patients (MES grade 2 and NHI grade 2 in the rectum) but were different for PSC-UC patients (MES grade 0 and NHI grade 2 in the cecum). There was a correlation between MES and NHI for UC patients (Spearman's r = 0.40, P = 0.029) but not for PSC-UC patients. Histopathological examination revealed persistent microscopic inflammation in 88% of PSC-UC patients with MES grade 0 (46% of all PSC-UC patients). Moreover, MES overestimated the severity of active inflammation in an additional 11% of PSC-UC patients.Conclusion: MES insufficiently identifies microscopic inflammation in PSC-UC. This indicates that histological evaluation should become a routine procedure of the diagnostic and grading system in both PSC-UC and PSC.","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"16 11","pages":"607-616"},"PeriodicalIF":1.4000,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586720/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Gastrointestinal Endoscopy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4253/wjge.v16.i11.607","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Ulcerative colitis (UC) with concomitant primary sclerosing cholangitis (PSC) represents a distinct disease entity (PSC-UC). Mayo endoscopic subscore (MES) is a standard tool for assessing disease activity in UC but its relevance in PSC-UC remains unclear.

Aim: To assess the accuracy of MES in UC and PSC-UC patients, we performed histological scoring using Nancy histological index (NHI).

Methods: MES was assessed in 30 PSC-UC and 29 UC adult patients during endoscopy. NHI and inflammation were evaluated in biopsies from the cecum, rectum, and terminal ileum. In addition, perinuclear anti-neutrophil cytoplasmic antibodies, fecal calprotectin, body mass index, and other relevant clinical characteristics were collected.

Results: The median MES and NHI were similar for UC patients (MES grade 2 and NHI grade 2 in the rectum) but were different for PSC-UC patients (MES grade 0 and NHI grade 2 in the cecum). There was a correlation between MES and NHI for UC patients (Spearman's r = 0.40, P = 0.029) but not for PSC-UC patients. Histopathological examination revealed persistent microscopic inflammation in 88% of PSC-UC patients with MES grade 0 (46% of all PSC-UC patients). Moreover, MES overestimated the severity of active inflammation in an additional 11% of PSC-UC patients.

Conclusion: MES insufficiently identifies microscopic inflammation in PSC-UC. This indicates that histological evaluation should become a routine procedure of the diagnostic and grading system in both PSC-UC and PSC.

查看原文本刊更多论文

溃疡性结肠炎合并原发性硬化性胆管炎时，梅奥内镜子评分的有效性有限。

背景：溃疡性结肠炎（UC）合并原发性硬化性胆管炎（PSC）是一种独特的疾病实体（PSC-UC）。梅奥内镜评分（MES）是评估 UC 疾病活动性的标准工具，但其在 PSC-UC 中的相关性仍不清楚。目的：为了评估 MES 在 UC 和 PSC-UC 患者中的准确性，我们使用南希组织学指数（NHI）进行了组织学评分：方法：在内窥镜检查期间，对30名PSC-UC和29名UC成人患者的MES进行评估。对盲肠、直肠和回肠末端的活组织切片进行了 NHI 和炎症评估。此外，还收集了核周抗中性粒细胞胞浆抗体、粪便钙蛋白、体重指数和其他相关临床特征：UC 患者的 MES 和 NHI 中位数相似（直肠 MES 2 级，NHI 2 级），但 PSC-UC 患者的 MES 和 NHI 中位数不同（盲肠 MES 0 级，NHI 2 级）。UC 患者的 MES 与 NHI 之间存在相关性（Spearman's r = 0.40，P = 0.029），但 PSC-UC 患者的 MES 与 NHI 之间不存在相关性。组织病理学检查显示，88%的 MES 为 0 级的 PSC-UC 患者（占所有 PSC-UC 患者的 46%）存在持续的显微炎症。此外，MES还高估了另外11%的PSC-UC患者活动性炎症的严重程度：结论：MES 无法充分识别 PSC-UC 中的微观炎症。这表明组织学评估应成为 PSC-UC 和 PSC 诊断和分级系统的常规程序。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

World Journal of Gastrointestinal Endoscopy GASTROENTEROLOGY & HEPATOLOGY-

自引率

5.00%

发文量

1164