Histological scoring systems in ulcerative colitis patients: a routine practice perspective

Introduction. Histological healing has become a therapeutic goal in patients with ulcerative colitis. However, a consensus on its precise definition has not been reached yet. A large number of complex histological scoring systems for ulcerative colitis are available in literature making standardization a complicated issue. The objective of the study was to identify a histological scoring system that is adequate for routine practice and thus contributes to standardization of histological reporting of inflammation activity in ulcerative colitis. Materials and methods. We retrospectively reviewed and scored 64 H&E stained slides using Nancy index (NI), Geboes score (GS) and Robarts Histopathology Index (RHI). The level of inter-rater and intra-rater agreement, time needed for scoring per slide, and correlation between the histological scores and Mayo endoscopic score were further analysed statistically. Results. The inter-rater agreement was very good for NI (kappa=0.861) and GS (kappa=0.820), and moderate for RHI (kappa=0.592), p