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Comparing the Continuous Geboes Score With the Robarts Histopathology Index: Definitions of Histological Remission and Response and their Relation to Faecal Calprotectin Levels

2019; Oxford University Press; Volume: 14; Issue: 2 Linguagem: Inglês

10.1093/ecco-jcc/jjz123

1876-4479

Fernando Magro, Joanne Lopes, Paula Borralho, Susana Lopes, Rosa Coelho, José Cotter, Francisca Dias de Castro, Helena Tavares de Sousa, Marta Salgado, Patrícia Andrade, Ana Vieira, Pedro Figueiredo, Paulo Caldeira, Ana Sousa, Maria Antónia Duarte, Filipa Ávila, João S. Silva, Joana Moleiro, Sofia Mendes, Sílvia Giestas, Paula Ministro, Paula Sousa, Raquel Gonçalves, Bruno Gonçalves, Ana Oliveira, Cristina Chagas, Marília Cravo, Cláudia Camila Dias, Joana Afonso, Francisco Portela, Mafalda Santiago, Karel Geboes, Fátima Carneiro,

Colorectal Cancer Surgical Treatments

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.This was an analysis of three prospective cohorts including 422 patients previously enrolled in other studies.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.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.