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P606 Is it necessary to include disease extent in endoscopic scoring in ulcerative colitis?

A. Balint*, K. Farkas, Z. Szepes, F. Nagy, R. Bor, A. Milassin, M. Rutka, T. Molnar

University of Szeged, First Department of Medicine, Szeged, Hungary

Background

Colonoscopy plays a crucial role in the establishment of diagnosis, management and follow-up of ulcerative colitis (UC). None of the current endoscopic scores consider the disease extent, and therefore does not correlate with the disease extension and does not reflect the real severity of UC. Our aim was to assess accuracy of a modification of widely used Endoscopic Mayo Score (eMayo) to reflect not only the severity, but the extension of acute flare in UC.

Methods

Pancolonic Modified Mayo Score (panMayo) was calculated. The eMayo scores of the involved area of the five colorectal segments (ascendens, transversum, descendens, sigma and rectum) were added, however to clearly distinguish the almost healing mucosa (eMayo 1 in each segment would effect a larger score than severe proctitis) from active inflammation, the sum was multiplied by 3.5 in the case of eMayo equal or greater than 2 (range 0 [normal] to 52.5 [most severe]). Fiftyfour UC patients were enrolled in this prospective study (the mean age: 42.9 years; male/female: 26/28). We compared panMayo score, eMayo and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) with serum and faecal inflammatory parameters and Riley score.

Results

All of tree assessed scores significantly correlate with Riley score (p<0.001). The panMayo score correlates with CRP (p<0.001), hematocrit (p=0.008), haemoglobin (p=0.002), trombocytes (p=0.035), serum iron (p<0.001) and MMP-9 (p<0.001). This score do not associate with number of leukocytes. Tendency correlation was shown with faecal calprotectin (p=0.08). Endoscopic Mayo score and UCEIS was also correlated with CRP (p=0.012 and p=0.016), MMP-9 (p=0.003 and p=0.004), leukocytes (p=0.047 and p=0.011), serum iron (p=0.003 and p=0.007), but not with hematocrit, haemoglobin, trombocytes and faecal calprotectin.

Conclusion

We suggest that panMayo score could be favourable due to it gives an additional information about disease location besides disease activity; in addition, it revealed a stronger correlation with laboratory parameters of inflammation than the other scores.