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P266 How disease extent can be included in the Endoscopic Activity Index of ulcerative colitis: the pan Mayo score, a promising scoring system

A. Bálint*1, K. Farkas1, Z. Szepes1, F. Nagy1, M. Szücs2, L. Tiszlavicz3, R. Bor1, A. Milassin1, M. Rutka1, A. Fábián4, T. Molnár5

1University of Szeged, 1st Department of Medicine, Szeged, Hungary, 2University of Szeged, Department of Medical Physics and Informatics, Szeged, Hungary, 3University of Szeged, Department of Pathology, Szeged, Hungary, 4University of Szeged, First Department of Medicine, Szeged, Hungary, 5University of Szeged, First Department of Medicine, Szeged, Hungary

Background

Colonoscopy plays crucial role in the establishment of diagnosis, management, and follow-up of ulcerative colitis (UC). None of the currently available endoscopic scores considers disease extent and, therefore, do not correlate with the real severity of UC. Our aim was to assess the accuracy of a modified, widely used Endoscopic Mayo Subs-core (eMayo) to reflect not only the severity but also the extent of active UC.

Methods

In total, 104 UC patients were enrolled in this prospective study. The eMayo Scores of the involved area of the 5 colorectal segments were added, and further to clearly distinguish the active and inactive disease the sum was multiplied by 3 in the case of eMayo ≥ 2 (range 0 [normal] to 45 [most severe]) to give the Pancolonic Modified Mayo Score (panMayo). 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 the assessed scores significantly correlated with Riley Score, CRP, haemoglobin, haematocrit, serum iron, faecal MMP-9, and calprotectin, but only the panMayo score correlated exclusively with the extent of UC. UCEIS correlated with eMayo and panMayo, and panMayo with eMayo. The panMayo Score showed sensitivity of 100% and specificity of 69.2%. UCEIS, eMayo and panMayo Score were associated with disease outcome, as well.

Conclusion

We suggest that this new score gives additional information about disease location, besides disease activity, with a strong correlation with laboratory parameters of inflammation.