Authors:

Abstract

In order to determine the role of the pathologist in assessing disease activity in UC, clinical and histological correlation of disease activity, correlation between endoscopy and histology and determining the most satisfactory method of scoring histological activity were assessed. A cohort of 41 patients attending a gastroenterology clinic in a tertiary hospital in Sri Lanka was studied. Their clinical activity was determined based on the simple clinical colitis activity index (SCCAI), endoscopically visible inflammation was recorded with reference to the extent of involvement and histology was assessed using three different histological scoring systems. The Spearman rank correlation coefficients between SCCAI and the three histological scoring systems were 0.298, 0.286, and 0.238 respectively denoting  poor correlation.  The kappa value of agreement between endoscopy and histology was poor (k=0.136). The Spearman rank correlation coefficients between the three histological scoring systems were 0.883,  0.883  and  0.952, reaching a level of statistical significance (p<0.01). The clinical activity and histological activity do not correlate and this is especially when assessing the more proximal colon. Endoscopy and histology also shows  no correlation highlighting the importance of microscopic assessment of endoscopically normal mucosa. Finally, the histological scoring systems correlate fairly closely with one another enabling histopathologists to choose one that is most practical for routine use.

Keywords: Ulcerative colitis, Disease activity, Histological activity assessment

How to Cite: Mahendra, B.A.G.G. and De S. Hewavisenthi, S.J., 2018. The role of the pathologist in the assessment of disease activity in ulcerative colitis. Journal of Diagnostic Pathology, 13(1), pp.5–15. DOI: http://doi.org/10.4038/jdp.v13i1.7749