Comparison of different histological indexes in the assessment of UC activity and their accuracy regarding endoscopic outcomes and faecal calprotectin levels

一致性 钙蛋白酶 胃肠病学 医学 内科学 活检 粪钙保护素 肠粘膜 病理 炎症性肠病 疾病
作者
Fernando Magro,Joanne Lopes,Paula Borralho,Susana Lopes,Rosa Coelho,José Cotter,Francisca Dias de Castro,Helena Tavares de Sousa,Marta Salgado,Patrícia Andrade,Ana Vieira,Pedro Figueiredo,Paulo Caldeira,A Sousa,Maria Antónia Duarte,Filipa Ávila,João Silva,Joana Moleiro,Sofia Mendes,Sílvia Giestas,Paula Ministro,Paula Sousa,Raquel Gonçalves,Bruno Gonçalves,Ana Maria Oliveira,Isadora Rosa,Marta Rodrigues,Cristina Chagas,Cláudia Camila Dias,Joana Afonso,Karel Geboes,Fátima Carneiro
出处
期刊:Gut [BMJ]
卷期号:68 (4): 594-603 被引量:78
标识
DOI:10.1136/gutjnl-2017-315545
摘要

Histological remission is being increasingly acknowledged as a therapeutic endpoint in patients with UC. The work hereafter described aimed to evaluate the concordance between three histological classification systems-Geboes Score (GS), Nancy Index (NI) and RobartsHistopathologyIndex (RHI), as well as to evaluate their association with the endoscopic outcomes and the faecal calprotectin (FC) levels.Biopsy samples from 377 patients with UC were blindly evaluated using GS, NI and RHI. The results were compared with the patients' Mayo Endoscopic Score and FC levels.GS, NI and RHI have a good concordance concerning the distinction between patients in histological remission or activity. RHI was particularly close to NI, with 100% of all patients classified as being in remission with NI being identified as such with RHI and 100% of all patients classified as having activity with RHI being identified as such with NI. These scores could also predict the Mayo Endoscopic Score and the FC levels, with their sensitivity and specificity levels depending on the chosen cut-offs. Moreover, higher FC levels were statistically associated with the presence of neutrophils in the epithelium, as well as with ulceration or erosion of the intestinal mucosa.GS, NI and RHI histopathological scoring systems are comparable in what concerns patients' stratification into histological remission/activity. Additionally, FC levels are increased when neutrophils are present in the epithelium and the intestinal mucosa has erosions or ulcers. The presence of neutrophils in the epithelium is, indeed, the main marker of histological activity.
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