Quantitative endoscopic and histologic activity assessment of ulcerative colitis

Abstract

Background: Correct assessment of the severity and activity of ulcerative colitis (UC) is necessary for determining effective treatment and predicting prognosis. The correlation between histologic activity and endoscopic activity, however, has not yet been determined by using a quantitative scoring system.

Study aims: To compare the endoscopic activity index (EAI), detected during colonoscopy, with the histologic activity index (HAI) detected in biopsy samples taken from the same colon segments of UC patients in order to determine the degree of agreement between both assessments.

Patients and methods: Ninety-six UC patients participated in this prospective study. EAIs and HAIs were obtained by summing the scores given for each mucosal/histological change to produce a total score between 1 and 12. The correlation between EAI and HAI was calculated.

Results: There was a positive correlation between HAI and EAI (r = 0.78; p < 0.001). There was no statistical inconsistency between the EAI and HAI results (p = 0.625, using the McNemar test). The whole group kappa coefficient was 0.607 (p < 0.001).

Conclusion: Endoscopic and histologic activity of mucosal disease in patients with UC are generally consistent. Measuring both histologic and endoscopic activity with a quantitative scoring system during patient follow-up would be a more accurate method for monitoring UC patients.