title: Assessment of the Correlation between Endoscopic Activity and Histological Activity in Ulcerative Colitis Patients.
abstract: OBJECTIVE
  The aim of this study was to assess the concordance between the Rachmilewitz endoscopic activity index (EAI) and the Harpaz histopathological activity scoring system (HSS), which are used for evaluating the disease activity of ulcerative colitis (UC).
  
  
  METHODS
  This study included 109 patients with UC. Based on the disease extent, patients were divided into two groups as left-sided colitis and pancolitis. Patients were grouped as inactive, mild, moderate and severe depending on the Rachmilewitz EAI and Harpaz HSS. Kendal's tau and kappa (x03BA;) statistics were used to assess the agreement between endoscopic and histopathological scores. A receiver operating characteristic (ROC) curve was also analyzed to evaluate the sensitivity and specificity of endoscopic scores to predict inactive histopathological disease.
  
  
  RESULTS
  In the left-sided colitis group, there were slight and poor agreements in the inactive endoscopic subscores (ESS) with inactive Harpaz HSS (x03BA;: 0.598, p < 0.001) and moderate ESS with moderate Harpaz HSS (x03BA;: 0.236, p = 0.046). There was no agreement between mild ESS and mild Harpaz HSS and between severe ESS and severe Harpaz HSS (x03BA;: 0.071, p = 0.573 and x03BA;: 0.160, p = 0.151, respectively). In the pancolitis group, there was no significant agreement between inactive, mild, moderate and severe ESS and the equivalent Harpaz HSS grades (x03BA;: -0.194, p = 0.187; x03BA;: 0.125, p = 0.397; x03BA;: 0.148, p = 0.175 and x03BA;: 0.174, p = 0.153, respectively). The ROC curve showed that the ESS indicating inactive disease had a low sensitivity to predict histologically inactive disease.
  
  
  CONCLUSIONS
  The concordance between the endoscopic and histopathological indices was poor. Using both scores in the follow-up of patients with UC is necessary for treatment planning.
authors.affiliation: Department of Pathology, Kex00E7;ix00F6;ren Training and Research Hospital, Ankara, Turkey.
authors.forename: Hulya Demirkaynak
authors.initials: HD
authors.lastname: Simsek
authors.forename: Sebahat
authors.initials: S
authors.lastname: Basyigit
authors.forename: Bora
authors.initials: B
authors.lastname: Aktas
authors.forename: Guler Gulcin
authors.initials: GG
authors.lastname: Simsek
authors.forename: Erdem
authors.initials: E
authors.lastname: Vargol
authors.forename: Metin
authors.initials: M
authors.lastname: Kucukazman
authors.forename: Yaşar
authors.initials: Y
authors.lastname: Nazlıgul
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003093:Colitis, Ulcerative / Q000145:classification / Q000473:pathology*; D003113:Colonoscopy / Q000592:standards*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult