Histologic Features of Colon Biopsies (Geboes Score) Associated With Progression of Ulcerative Colitis for the First 36 Months After Biopsy

Data de publicação: 01/12/2021 Data Ahead of Print: 01/11/2021

Autores da FMUP

• Fernando José Magro Dias

  Autor

• Susana Isabel Oliveira Lopes

  Autor

• João Manuel Costa Ferreira Torres

  Autor

• Claudia Camila Rodrigues Pereira Dias

  Autor

• Maria De Fátima Machado Henriques Carneiro

  Autor

Participantes de fora da FMUP

• Alves, C
• Lopes, J
• de Sousa, HT
• Cotter, J
• da Silva, VM
• Lago, P
• Vieira, A
• Brito, M
• Duarte, MAM
• Portela, F
• Silva, JP
• Ministro, P
• Arroja, B
• Carvalho, L
• Santiago, M
• Estevinho, MM
• Danese, S
• Peyrin Biroulet, L
• Borralho, P
• Feakins, RM

Unidades de investigação

• Biomedicina

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina

• Patologia

• Recursos Comuns

  

  Investigador

  Guilhermina Maria Da Silva Rêgo

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

BACKGROUND & AIMS: In addition to findings from endoscopy, histologic features of colon biopsies have been associated with outcomes of patients with ulcerative colitis (UC). We investigated associations between Geboes scores (a system to quantify structural changes and inflammatory activity in colon biopsies) and UC progression, and the time period over which this association is valid. METHODS: We analyzed data from 399 asymptomatic patients with UC enrolled in the ACERTIVE study, followed at 13 inflammatory bowel disease (IBD) centers in Portugal through 31 December 2019. Blood and stool samples were collected and analyzed, and all patients underwent sigmoidoscopy within 24 h of sample collection. We assessed baseline endoscopic status (Mayo endoscopic subscore), histologic features of 2 sigmoid and 2 rectal biopsies (Geboes score), and concentration of fecal calprotectin (FC). The primary outcome was UC progression (surgical, pharmacologic, and clinical events). We generated survival curves for 36 months or less and more than 36 months after biopsy according to Geboes score using the Kaplan-Meier method and compared findings with those from a log rank test. Cox regression was adjusted for Mayo endoscopic subscore, Geboes score, and level of FC; results were expressed as adjusted hazard ratios (HR) with 95% CIs. RESULTS: Patients with Geboes scores >2B.0, Geboes scores >3.0, or Geboes scores >4.0 had a higher frequency of, and a shorter time to UC progression, than patients with Geboes scores <= 2B.0, Geboes scores <= 3.0, or Geboes score <= 4.0 (P < .001). Disease progression occurred earlier in patients with Geboes scores >2B.0, Geboes scores >3.0, or Geboes scores >4.0 compared with patients with Geboes scores <= 2B.0 (HR, 2.021; 95% CI, 1.158-3.526), Geboes scores <= 3.0 (HR, 2.007; 95% CI, 1.139-3.534), or Geboes scores <= 4.0 (HR, 2.349; 95% CI, 1.269-4.349), respectively, in the first 36 months after biopsy. Similar results were found for patients with concentrations of FC below 150 mu g/g. CONCLUSIONS: We found histologic features of colon biopsies (Geboes score) to be an independent risk factor for progression of UC in the first 36 months after biopsy.

Keywords

• Colonoscopy; Fecal; Biomarker; Prognostic Factor