ECCO Position Paper: Harmonization of the Approach to Ulcerative Colitis Histopathology

Data de publicação:

Autores da FMUP

  • Fernando José Magro Dias

    Autor

  • Maria De Fátima Machado Henriques Carneiro

    Autor

Participantes de fora da FMUP

  • Doherty, G
  • Peyrin Biroulet, L
  • Svrcek, M
  • Borralho, P
  • Walsh, A
  • Rosini, F
  • de Hertogh, G
  • Biedermann, L
  • Pouillon, L
  • Scharl, M
  • Tripathi, M
  • Danese, S
  • Villanacci, V
  • Feakins, R

Unidades de investigação

Abstract

Currently, the main targets of drug therapy for ulcerative colitis IUC] are endoscopic and clinical remission. However, there is active discussion about the additional advantages of including histological remission as a target. Accumulating evidence indicates that microscopic activity persists in endoscopically quiescent UC, that histological changes may lag behind clinical remission after treatment, and that absence of histological activity predicts lower rates of relapse, hospitalization, surgery and subsequent neoplasia. Obtaining useful information from mucosal biopsies in this setting depends on accurate and consistent evaluation of histological features. However, there is no standardization of biopsy procedures, histological sample processing technique or histological scoring systems, and there is no agreement on the definitions of histological remission, response or activity. Accordingly, a consensus expert panel convened by the European Crohn's and Colitis Organisation [ECCO] reviewed the literature and agreed a number of position statements regarding harmonization of UC histopathology.The objective was to provide evidence-based guidance for the standardization and harmonization of procedures, definitions and scoring systems for histology in UC, and to reach expert consensus where possible. We propose the absence of intraepithelial neutrophils, erosion and ulceration as a minimum requirement for the definition of histological remission. For randomized control trials we recommend the use of the Robarts histopathology index [RHI] or the Nancy index [NI]. For observational studies or in clinical practice we recommend the use of the NI.To predict the risk of future neoplasia in UC, cumulative histological scores over time are more useful than single scores.

Dados da publicação

ISSN/ISSNe:
1873-9946, 1876-4479

JOURNAL OF CROHNS & COLITIS  Oxford University Press

Tipo:
Article
Páginas:
1503-1511
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 86

Citações Recebidas na Scopus: 121

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Keywords

  • Clinical trials histology; histopathology; ulcerative colitis

Proyectos asociados

Gastric Cancer Morphological, Immunophenotypic and molecular heterogeneity

Investigador Principal: Maria de Fátima Machado Henriques Carneiro

Estudo Clínico Académico . 2020

Contributo da endoscopia, biomarcadores e imagiologia na evolução clinica dos doentes com doença inflamatória intestinal

Investigador Principal: Fernando José Magro Dias

Estudo Clínico Académico . 2019

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