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Thématique :
- MICI
Originalité :
Intermédiaire
Solidité :
Très solide
Doit faire évoluer notre pratique :
Immédiatement
 
 
Nom du veilleur :
Docteur Patrick FAURE
Coup de coeur :
 
 
Gut
  2015/09  
 
  2015 Sep;64(9):1412-8  
  doi: 10.1136/gutjnl-2014-307477  
 
  Comparing histological activity indexes in UC  
 
  Bressenot A, Salleron J, Bastien C, Danese S, Boulagnon-Rombi C, Peyrin-Biroulet L  
  http://gut.bmj.com/content/early/2014/09/22/gutjnl-2014-307477.abstract  
 
 

Background
Assessment of disease activity in UC is important for designing an optimal therapeutic strategy. No single histology score is considered optimum. The aim of this study was to compare intraobserver reproducibility and the interobserver agreement of available histological UC activity indexes.

Methods
One hundred and two biopsy specimens (collected between 2003 and 2014) were scored blindly by three pathologists by determining Geboes, Riley, Gramlich and Gupta indexes and global visual evaluation (GVE). Intraobserver reproducibility and interobserver agreements for index and items of index were studied by intraclass correlation coefficient for quantitative parameter and by κ values and Krippendorff index for qualitative parameters. Relationship between indexes was studied by computation of Pearson's and Spearman's correlation coefficients.

Results
Geboes, Riley, Gramlich and Gupta indexes and GVE showed good intraobserver reproducibility and a good interobserver agreement. Histological items that showed the best interobserver agreement were ‘erosion/ulceration or surface epithelial integrity’ and ‘acute inflammatory cells infiltrate/neutrophils in lamina propria’. The five scores were strongly correlated.

Conclusions
Correlation between indexes is strong. Intraobserver reproducibility and interobserver agreement for all indexes is very good. Histological items that showed the best interobserver agreement are ‘erosion/ulceration’ and ‘acute inflammatory cells infiltrate/neutrophils in lamina propria’.

 
Question posée
 
La cicatrisation endoscopique semble être le but ultime de la cicatrisation muqueuse dans la RCH. Comparer la reproductibilité intra et inter observateur des différents scores histologiques puisque il n’existe pas un score unique référent.
 
Question posée
 
La corrélation entre les différents index est forte. La reproductibilité intra et inter observateur est très bonne. Les signes histologiques avec la meilleure concordance inter-observateur sont la présence d’érosion, d’ulcération, d’une inflammation aiguë avec infiltration de neutrophiles au niveau de la lamina propria.
 
Commentaires

Ces éléments sont à prendre en compte dans la pratique clinique dans l’évaluation future de la cicatrisation histologique.

 
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