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Nancy histological index in ulcerative colitis: an interobserver study
Melissa C Hutchings1, Adrian C Bateman2
1Department of Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Interobserver agreement for the Nancy histological index in ulcerative colitis showed moderate reliability among pathologists. Standardization or AI tools may enhance consistency in assessing colorectal biopsy disease activity.
Area of Science:
- Gastroenterology
- Histopathology
Background:
- The Nancy histological index (NHI) assesses disease activity in ulcerative colitis (UC) biopsies.
- NHI is a predictor of clinical outcomes in UC patients.
Purpose of the Study:
- To measure interobserver agreement (IOA) in NHI scoring among pathologists.
- To identify areas of subjectivity in NHI assessment for UC.
Main Methods:
- Twenty colorectal biopsies from UC patients were scored by 13 pathologists.
- Interobserver agreement was quantified using Fleiss' kappa statistic.
Main Results:
- Moderate IOA was observed, with kappa scores ranging from 0.50 to 0.54.
- Reproducibility was highest for normal biopsies and mild chronic inflammation.
- Subjectivity was noted in assessing acute inflammation and ulceration.
Conclusions:
- Current NHI scoring demonstrates moderate reliability among pathologists.
- Pathologist education or artificial intelligence tools could improve IOA for UC histological assessment.
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