International consensus to standardise histopathological scoring for small bowel strictures in Crohn's disease
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View abstract on PubMed
Summary
This summary is machine-generated.Developing validated histopathology scoring systems for small bowel Crohn's disease (CD) strictures is crucial. Current systems are inappropriate for clinical trials, hindering drug development for this condition.
Area Of Science
- Gastroenterology
- Pathology
- Clinical Trials
Background
- Small bowel Crohn's disease (CD) strictures lack effective medical therapies and validated outcome measures for clinical trials.
- Histopathology of resected specimens is the gold standard for correlating with imaging, but no validated scoring systems exist for small bowel strictures.
Purpose Of The Study
- To evaluate the appropriateness of histopathology scoring systems and items for small bowel CD strictures.
- To establish criteria for diagnosing and assessing strictures and associated inflammation.
Main Methods
- A modified RAND/University of California Los Angeles methodology was employed.
- An expert panel assessed 313 candidate items for assessing CD small bowel strictures.
- Definitions for stricture features, sampling parameters, and active/chronic inflammation were established.
Main Results
- Specific histopathological definitions for strictures, active inflammation, and chronic inflammation were identified.
- Key diagnostic features for strictures include increased bowel wall thickness, decreased luminal diameter, and submucosal fibrosis.
- None of the existing scoring systems were deemed appropriate for clinical trials assessing CD strictures.
Conclusions
- Standardized assessment of gross and histopathology is essential for small bowel CD strictures.
- Improved assessment will enhance clinical trial efficiency and facilitate drug development for Crohn's disease.
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