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

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 

机构地区：[1]Department of Gastroenterology,Institute for Clinical and Experimental Medicine,Prague 14021,Czech Republic [2]Department of Integrative Biology,Institute of Molecular Genetics of the Czech Academy of Sciences,Prague 14220,Czech Republic [3]Department of Metabolism and Diabetes,Institute for Clinical and Experimental Medicine,Prague 14021,Czech Republic [4]Clinical and Transplant Pathology Centre,Institute for Clinical and Experimental Medicine,Prague 14021,Czech Republic [5]Department of Data Analysis,Statistics and Artificial Intelligence,Institute for Clinical and Experimental Medicine,Prague 14021,Czech Republic

出　　处：《World Journal of Gastrointestinal Endoscopy》2024年第11期607-616,共10页世界胃肠内镜杂志（英文）

基　　金：Supported by Grant Agency of the Ministry of Health of the Czech Republic,No.NV17-31538A;Grant Agency of the Czech Republic No.20-16520Y and No.21-21736S;Ministry of Education,Youth and Sports of the Czech Republic Project,No.LX22NPO05102.

摘　　要：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 PSCUC 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.

关 键 词：Primary sclerosing cholangitis Ulcerative colitis Diagnosis Nancy histological index Mayo endoscopic subscore 

分 类 号：R575.7[医药卫生—消化系统]