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

World Journal of Gastrointestinal Endoscopy 2024年第11期16卷 607-616页

作者： Pavel Wohl Alzbeta Krausova Petr Wohl Ondrej Fabian Lukas Bajer Jan Brezina Pavel Drastich Mojmir Hlavaty petra novotna Michal Kahle Julius Spicak Martin Gregor Department of Gastroenterology Institute for Clinical and Experimental MedicinePrague 14021Czech Republic Department of Integrative Biology Institute of Molecular Genetics of the Czech Academy of SciencesPrague 14220Czech Republic Department of Metabolism and Diabetes Institute for Clinical and Experimental MedicinePrague 14021Czech Republic Clinical and Transplant Pathology Centre Institute for Clinical and Experimental MedicinePrague 14021Czech Republic Department of Data Analysis Statistics and Artificial IntelligenceInstitute for Clinical and Experimental MedicinePrague 14021Czech Republic

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 *** 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 *** and inflammation were evaluated in biopsies from the cecum,rectum,and terminal *** addition,perinuclear anti-neutrophil cytoplasmic antibodies,fecal calprotectin,body mass index,and other relevant clinical characteristics were *** 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 *** 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 PSCUC *** MES insufficiently identifies microscopic inflammation in *** indicates that histological evaluation should become a routine procedure of the diagnostic and grading system in both PSC-UC and PSC.

关键词： Primary sclerosing cholangitis Ulcerative colitis Diagnosis Nancy histological index Mayo endoscopic subscore

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