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P517 Activity assessment in ulcerative colitis: correlation analysis of endoscopic and histological scores

M. Di Ruscio*1, A. Variola1, A. Geccherle1, S. Orlandi1, G. Lunardi2, P. Castelli3, G. Zamboni3, R. Riddell4

1IRCCS Sacro Cuore Don Calabria, IBD Unit, Negrar, Italy, 2IRCCS Sacro Cuore Don Calabria, Division of Medical Oncology, Negrar, Italy, 3IRCCS Sacro Cuore Don Calabria, Department of Pathology, Negrar, Italy, 4Mount Sinai Hospital University of Toronto, Department of Pathology and Laboratory Medicine, Toronto, Canada


The assessment of endoscopic and histological activity in patients with ulcerative colitis (UC) is essential in daily clinical practice, especially for therapy management. Numerous studies have correlated endoscopy and histology using different unvalidated or partially validated scores with controversial results. Recently new validated scores, as the ulcerative colitis index of severity (UCEIS) and the Nancy histological index (NHI), have been developed but their use in clinical practice is still limited. Furthermore, there is a lack of evidence about the correlation between validated endoscopic and histological indices. Aim of the study was to conduct a correlation analysis between endoscopic and histological activity using the UCEIS and NHI in a cohort of UC patients undergoing a biological treatment.


A single-centre retrospective analysis was conducted. We enrolled adults patients with moderate-to-severe UC who underwent a colonoscopy with biopsies at baseline before starting a biological treatment, and after a median of 48 weeks of treatment (control time). The assessment of disease activity was evaluated for the worst affected colonic segment, by using both the Mayo endoscopic subscore (MES) and the UCEIS for endoscopy and NHI for histology. Remission was defined as MES <2, UCEIS <2 and NHI <2. Spearman correlation analysis between the indices was performed. A p-value of less than 0.001 was considered statistically significant.


Sixty-one patients were included. Twenty-eight patients were treated with Infliximab (IFX), 10 with Adalimumab (ADA), 20 with Golimumab (GOL), 3 with Vedolizumab (VDZ). At control time 42.6% (26/61), 29.5% (18/61) and 26.2% (16/61) achieved endoscopic and histological remission according to the MES, UCEIS and NHI, respectively. The analysis showed a statistically significant correlation between MES and NHI (r = 0.70; p < 0.001), higher between UCEIS and NHI (r = 0.81; p < 0.001). The correlation was high both for active and inactive disease.


The UCEIS correlates with NHI strongly and better than MES.