Correlation between endoscopic and histological validated scoring indices in Crohn's disease

Area of Science:

• Gastroenterology
• Inflammatory Bowel Disease Research
• Clinical Endoscopy

Background:

• Accurate assessment of Crohn's disease (CD) activity is vital, requiring both endoscopic and histopathological evaluation.
• However, the correlation between validated endoscopic and histological indices for CD has not been thoroughly established.
• This gap hinders precise disease monitoring and treatment efficacy assessment.

Purpose of the Study:

• To correlate the Simple Endoscopic Score for Crohn's disease (SES-CD) with two established histological scoring systems.
• To validate the SES-CD's ability to reflect histological disease activity in patients with established CD.
• To determine the SES-CD threshold indicative of histological remission.

Main Methods:

• The SES-CD was assessed at the most affected site in 143 patients with established CD.
• Histological disease activity was independently scored by two blinded pathologists using the Global Histologic Disease Activity Score (GHAS) and the Naini and Cortina Score (NCS).
• Spearman correlation analysis was employed to evaluate the relationship between SES-CD, GHAS, and NCS.

Main Results:

• A strong positive correlation was observed between SES-CD and GHAS (r=0.86) and between SES-CD and NCS (r=0.85).
• The two histological indices also showed a strong correlation (r=0.70).
• A SES-CD score of 0 or 1 was most strongly associated with mucosal healing and absent histological disease activity.

Conclusions:

• The SES-CD is a reliable endoscopic tool that strongly correlates with validated histological indices (GHAS and NCS) in Crohn's disease.
• An SES-CD score of 0 to 1 effectively represents histological remission, indicating quiescent disease activity.
• These findings support the use of SES-CD for monitoring disease activity and guiding treatment decisions in CD.