Fernando Magro1,2, Joanne Lopes3, Paula Borralho4, Susana Lopes1, Rosa Coelho1, José Cotter5, Francisca Dias de Castro5, Helena Tavares de Sousa6,7, Marta Salgado8, Patrícia Andrade1, Ana Isabel Vieira9, Pedro Figueiredo9, Paulo Caldeira10, A Sousa10, Maria A Duarte11, Filipa Ávila11, João Silva12, Joana Moleiro12, Sofia Mendes13, Sílvia Giestas13, Paula Ministro14, Paula Sousa14, Raquel Gonçalves15, Bruno Gonçalves15, Ana Oliveira16, Cristina Chagas17, Marilia Cravo18, Cláudia Camila Dias19,20, Joana Afonso2,21, Francisco Portela13, Mafalda Santiago20, Karel Geboes22, Fátima Carneiro3,23. 1. Department of Gastroenterology, Faculty of Medicine, Centro Hospitalar São João, Porto, Portugal. 2. Department of Biomedicine, Unity of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal. 3. Department of Pathology, Centro Hospitalar São João, Porto, Portugal. 4. Institute of Pathology, Faculty of Medicine, University of Lisbon, Lisbon, Portugal. 5. Department of Gastroenterology, Hospital da Senhora da Oliveira, Guimarães, Portugal. 6. Department of Gastroenterology, Centro Hospitalar do Algarve - Portimão Unit, Portimão, Portugal. 7. ABC - Algarve Biomedical Centre, University of Algarve, Faro, Portugal. 8. Department of Gastroenterology, Centro Hospitalar do Porto, Hospital de Santo António, Portugal. 9. Department of Gastroenterology, Hospital Garcia de Orta, Almada, Portugal. 10. Department of Gastroenterology, Centro Hospitalar do Algarve, Faro, Portugal. 11. Department of Gastroenterology, Divino Espírito Santo Hospital, Ponta Delgada, Portugal. 12. Department of Gastroenterology, Instituto Português do Oncologia de Lisboa, Lisbon, Portugal. 13. Department of Gastroenterology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. 14. Department of Gastroenterology, Centro Hospitalar Tondela-Viseu, Viseu, Portugal. 15. Department of Gastroenterology, Hospital de Braga, Braga, Portugal. 16. Department of Gastroenterology, Hospital Fernando Fonseca, Amadora, Portugal. 17. Department of Gastroenterology, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal. 18. Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal. 19. Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal. 20. CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal. 21. MedInUP, Centre for Drug Discovery and Innovative Medicines, University of Porto, Porto, Portugal. 22. Department of Pathology, University Hospital of KU Leuven and UZ Gent, Leuven, Belgium. 23. Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), University of Porto, Porto, Portugal.
Abstract
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.
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.
Authors: Fangwen Zou; Xuemei Wang; Isabella C Glitza Oliva; Jennifer L McQuade; Jennifer Wang; Hao Chi Zhang; John A Thompson; Anusha S Thomas; Yinghong Wang Journal: J Immunother Cancer Date: 2021-01 Impact factor: 13.751
Authors: Lianne Heuthorst; Aart Mookhoek; Manon E Wildenberg; Geert R D'Haens; Willem A Bemelman; Christianne J Buskens Journal: United European Gastroenterol J Date: 2021-11-09 Impact factor: 4.623
Authors: Aaron M Gruver; Matt D Westfall; Bradley L Ackermann; Salisha Hill; Ryan D Morrison; Juraj Bodo; Keith K Lai; David C Gemperline; Eric D Hsi; Daniel C Liebler; Jochen Schmitz; Robert J Benschop Journal: J Clin Pathol Date: 2021-08-05 Impact factor: 4.463