Abstract
BackgroundColonoscopy plays crucial role in the establishment of the diagnosis, management and follow-up of ulcerative colitis (UC). None of the currently widely used endoscopic scores consider disease extent, and therefore do not correlate with the real severity of UC. Our aim was to assess the accuracy of a new score, the Pancolonic Modified Mayo Score that can reflect not only the severity, but the extent of active UC.MethodsOne hundred and four UC patients were enrolled in this prospective study. The Endoscopic Mayo Scores of the involved area of the five colorectal segments were added; furthermore, the sum was multiplied by 3 in case of eMayo ≥2 (range 0 [normal] to 45 [most severe]) to obtain the Pancolonic Modified Mayo Score (panMayo) in order to clearly distinguish the active and inactive disease. We analysed the correlation of panMayo Score with eMayo and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and complicated disease outcome. We compared the endoscopic indices with serum and faecal inflammatory parameters and Riley Score.ResultsThe panMayo Score correlated with eMayo and UCEIS. Every endoscopic score showed correlation with Riley Score, CRP, haemoglobin, haematocrit, serum iron, faecal MMP-9 and calprotectin and also predicted a complicated disease outcome. Only panMayo score correlated exclusively with the extent of UC.ConclusionsWe suggest that this new score gives additional information about disease extent besides disease activity with a strong correlation with laboratory parameters of inflammation and with the other widely used endoscopic indices.
Highlights
Colonoscopy plays crucial role in the establishment of the diagnosis, management and follow-up of ulcerative colitis (UC)
We found Pancolonic Modified Mayo Score (panMayo) Score to correlate with C-reactive protein (CRP) (R = 0.5; p < 0.001), faecal MMP-9 (R = 0.5; p < 0.001), calprotectin (R = 0.35; p < 0.043), leucocyte (R = 0.3; p = 0.009), thrombocyte levels (R = 0.3; p = 0.003), and with haemoglobin (R = −0.3; p = 0.001), haematocrit (R = −0.3; p = 0.004) and serum iron level (R = −0.5; p < 0.001) (Table 4)
Correlation between indices The panMayo Score correlated with Endoscopic Mayo Subscore (eMayo) (R = 0.853; p < 0.001) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) (R = 0.783; p < 0.001), and eMayo with UCEIS as well (R = 0.932; p < 0.001)
Summary
Colonoscopy plays crucial role in the establishment of the diagnosis, management and follow-up of ulcerative colitis (UC). None of the currently widely used endoscopic scores consider disease extent, and do not correlate with the real severity of UC. Our aim was to assess the accuracy of a new score, the Pancolonic Modified Mayo Score that can reflect the severity, but the extent of active UC. The most widely used ones are the Mayo Score, and the validated [4] Ulcerative Colitis Endoscopic Index of Severity (UCEIS) [1]. Both of these scores assess vascular pattern, presence of erythema, friability, erosions, ulcerations and bleeding [5, 6].
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