Autor(es):
Magro, Fernando ; Lopes, Joanne ; Borralho, Paula ; Lopes, Susana ; Coelho, Rosa ; Cotter, Jose ; de Castro, Francisca Dias ; Sousa, Helena Tavares ; Salgado, Marta ; Andrade, Patricia ; Vieira, Ana Isabel ; Figueiredo, Pedro ; Caldeira, Paulo ; Sousa, A. ; Duarte, Maria A. ; Avila, Filipa ; Silva, Joao ; Moleiro, Joana ; Mendes, Sofia ; Giestas, Silvia ; Ministro, Paula ; Sousa, Paula ; Goncalves, Raquel ; Goncalves, Bruno ; Oliveira, Ana ; Chagas, Cristina ; Cravo, Marilia ; Dias, Claudia Camila ; Afonso, Joana ; Portela, Francisco ; Santiago, Mafalda ; Geboes, Karel ; Carneiro, Fatima
Data: 2020
Identificador Persistente: http://hdl.handle.net/10400.1/16586
Origem: Sapientia - Universidade do Algarve
Assunto(s): Endoscopic activity; Histological activity; Ulcerative colitis
Descrição
Background and Aims: The histological status of ulcerative colitis [UC] patients in clinical and endoscopic remission has gained space as an important prognostic marker and a key component of disease monitoring. Our main aims were to compare two histological indexes-the continuous Geboes score [GS] and the Robarts Histopathology index [RHI]-regarding their definitions of histological remission and response, and the ability of faecal calprotectin [FC] levels to discriminate between these statuses. Methods: This was an analysis of three prospective cohorts including 422 patients previously enrolled in other studies. Results: The two continuous scores [GS and RHI] were shown to be significantly correlated [correlation coefficient of 0.806, p < 0.001] and particularly close regarding their definition of histological response: 95% and 88% of all patients classified as having/not having [respectively] histological response according to RHI also did so according to GS. Moreover, median FC levels in patients with histological response were lower than those in patients without histological response [GS: 73.00 vs 525.00, p < 0.001; RHI: 73.50 vs 510.00, p < 0.001]; a similar trend was observed when FC levels of patients in histological remission were compared to those of patients with histological activity [GS: 76.00 vs 228.00, p < 0.001; RHI: 73.50 vs 467.00, p < 0.001]. FC levels allowed us to exclude the absence of histological remission [according to RHI] and absence of histological response [according to RHI and GS], with negative predictive values varying from 82% to 96%. However, optimization of the FC cut-off to exclude the absence of histological remission, as for the continuous GS, falls within values that resemble those of the healthy population. Conclusion: The continuous GS and RHI histological scores are strongly correlated in their definitions of histological response. An absence of histological remission could only be excluded at physiological levels of FC.
