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J Crohns Colitis. 2019 Sep 4. pii: jjz123. doi: 10.1093/ecco-jcc/jjz123. [Epub ahead of print]

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

Author information

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.

KEYWORDS:

endoscopic activity; histological activity; ulcerative colitis

PMID:
31504348
DOI:
10.1093/ecco-jcc/jjz123

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