Limited validity of Mayo endoscopic subscore in ulcerative colitis with concomitant primary sclerosing cholangitis
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. To assess the accuracy of MES in UC and PSC...
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Veröffentlicht in: | World journal of gastrointestinal endoscopy 2024-11, Vol.16 (11), p.607-616 |
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creator | Wohl, Pavel Krausova, Alzbeta Wohl, Petr Fabian, Ondrej Bajer, Lukas Brezina, Jan Drastich, Pavel Hlavaty, Mojmir Novotna, Petra Kahle, Michal Spicak, Julius Gregor, Martin |
description | 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.
To assess the accuracy of MES in UC and PSC-UC patients, we performed histological scoring using Nancy histological index (NHI).
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.
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
= 0.40,
= 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.
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. |
doi_str_mv | 10.4253/wjge.v16.i11.607 |
format | Article |
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To assess the accuracy of MES in UC and PSC-UC patients, we performed histological scoring using Nancy histological index (NHI).
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.
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
= 0.40,
= 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.
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.</description><identifier>ISSN: 1948-5190</identifier><identifier>EISSN: 1948-5190</identifier><identifier>DOI: 10.4253/wjge.v16.i11.607</identifier><identifier>PMID: 39600557</identifier><language>eng</language><publisher>United States: Baishideng Publishing Group Inc</publisher><subject>Prospective Study</subject><ispartof>World journal of gastrointestinal endoscopy, 2024-11, Vol.16 (11), p.607-616</ispartof><rights>The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.</rights><rights>The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved. 2024</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c238t-5d065298db945c55edeeeb230e054b8712b9b774303097c535b885996d05f4413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586720/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586720/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39600557$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wohl, Pavel</creatorcontrib><creatorcontrib>Krausova, Alzbeta</creatorcontrib><creatorcontrib>Wohl, Petr</creatorcontrib><creatorcontrib>Fabian, Ondrej</creatorcontrib><creatorcontrib>Bajer, Lukas</creatorcontrib><creatorcontrib>Brezina, Jan</creatorcontrib><creatorcontrib>Drastich, Pavel</creatorcontrib><creatorcontrib>Hlavaty, Mojmir</creatorcontrib><creatorcontrib>Novotna, Petra</creatorcontrib><creatorcontrib>Kahle, Michal</creatorcontrib><creatorcontrib>Spicak, Julius</creatorcontrib><creatorcontrib>Gregor, Martin</creatorcontrib><title>Limited validity of Mayo endoscopic subscore in ulcerative colitis with concomitant primary sclerosing cholangitis</title><title>World journal of gastrointestinal endoscopy</title><addtitle>World J Gastrointest Endosc</addtitle><description>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.
To assess the accuracy of MES in UC and PSC-UC patients, we performed histological scoring using Nancy histological index (NHI).
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.
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
= 0.40,
= 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.
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.</description><subject>Prospective Study</subject><issn>1948-5190</issn><issn>1948-5190</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNpVkU1vGyEQhlHVKo6c3HOqOPZiZ1hgWU5VZfUjkqNc0jNi2bGNtV5cYB353xcrruXOZQbxzjszegh5YDAXleSPb9s1zg-snnvG5jWoD-SWadHMJNPw8aqekPuUtlBCCAVM3ZAJ1zWAlOqWxKXf-YwdPdjedz4faVjRZ3sMFIcuJBf23tE0tqWKSP1Ax95htNkfkLrQ--wTffN5Ux6DC8XKDpnuo9_ZeKTJ9RhD8sOauk3o7bA-6e_Ip5XtE96f85T8_vH9dfFrtnz5-bT4tpy5ijd5JjuoZaWbrtVCOimxQ8S24oAgRdsoVrW6VUpw4KCVk1y2TSO1rjuQKyEYn5Kv7777sd1h53DI0fbmvJwJ1pv_fwa_MetwMIzJplYVFIcvZ4cY_oyYstn55LAvl2AYk-GMc1FXGk5SeJe6cnCKuLrMYWBOuMwJlym4TMFlCq7S8vl6v0vDPzj8L2uulTA</recordid><startdate>20241116</startdate><enddate>20241116</enddate><creator>Wohl, Pavel</creator><creator>Krausova, Alzbeta</creator><creator>Wohl, Petr</creator><creator>Fabian, Ondrej</creator><creator>Bajer, Lukas</creator><creator>Brezina, Jan</creator><creator>Drastich, Pavel</creator><creator>Hlavaty, Mojmir</creator><creator>Novotna, Petra</creator><creator>Kahle, Michal</creator><creator>Spicak, Julius</creator><creator>Gregor, Martin</creator><general>Baishideng Publishing Group Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20241116</creationdate><title>Limited validity of Mayo endoscopic subscore in ulcerative colitis with concomitant primary sclerosing cholangitis</title><author>Wohl, Pavel ; Krausova, Alzbeta ; Wohl, Petr ; Fabian, Ondrej ; Bajer, Lukas ; Brezina, Jan ; Drastich, Pavel ; Hlavaty, Mojmir ; Novotna, Petra ; Kahle, Michal ; Spicak, Julius ; Gregor, Martin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c238t-5d065298db945c55edeeeb230e054b8712b9b774303097c535b885996d05f4413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Prospective Study</topic><toplevel>online_resources</toplevel><creatorcontrib>Wohl, Pavel</creatorcontrib><creatorcontrib>Krausova, Alzbeta</creatorcontrib><creatorcontrib>Wohl, Petr</creatorcontrib><creatorcontrib>Fabian, Ondrej</creatorcontrib><creatorcontrib>Bajer, Lukas</creatorcontrib><creatorcontrib>Brezina, Jan</creatorcontrib><creatorcontrib>Drastich, Pavel</creatorcontrib><creatorcontrib>Hlavaty, Mojmir</creatorcontrib><creatorcontrib>Novotna, Petra</creatorcontrib><creatorcontrib>Kahle, Michal</creatorcontrib><creatorcontrib>Spicak, Julius</creatorcontrib><creatorcontrib>Gregor, Martin</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of gastrointestinal endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wohl, Pavel</au><au>Krausova, Alzbeta</au><au>Wohl, Petr</au><au>Fabian, Ondrej</au><au>Bajer, Lukas</au><au>Brezina, Jan</au><au>Drastich, Pavel</au><au>Hlavaty, Mojmir</au><au>Novotna, Petra</au><au>Kahle, Michal</au><au>Spicak, Julius</au><au>Gregor, Martin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Limited validity of Mayo endoscopic subscore in ulcerative colitis with concomitant primary sclerosing cholangitis</atitle><jtitle>World journal of gastrointestinal endoscopy</jtitle><addtitle>World J Gastrointest Endosc</addtitle><date>2024-11-16</date><risdate>2024</risdate><volume>16</volume><issue>11</issue><spage>607</spage><epage>616</epage><pages>607-616</pages><issn>1948-5190</issn><eissn>1948-5190</eissn><abstract>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.
To assess the accuracy of MES in UC and PSC-UC patients, we performed histological scoring using Nancy histological index (NHI).
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.
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
= 0.40,
= 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.
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.</abstract><cop>United States</cop><pub>Baishideng Publishing Group Inc</pub><pmid>39600557</pmid><doi>10.4253/wjge.v16.i11.607</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Prospective Study |
title | Limited validity of Mayo endoscopic subscore in ulcerative colitis with concomitant primary sclerosing cholangitis |
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