TY - JOUR
T1 - Histologic features of colon biopsies (Geboes Score) associated with progression of ulcerative colitis for the first 36 months after biopsy
AU - Magro, Fernando
AU - Alves, Catarina
AU - Lopes, Joanne
AU - Lopes, Susana
AU - Tavares de Sousa, Helena
AU - Cotter, José
AU - Macedo da Silva, Vitor
AU - Lago, Paula
AU - Vieira, Ana
AU - Brito, Mariana
AU - Duarte, Maria A.M.
AU - Portela, Francisco
AU - Silva, João P.
AU - Ministro, Paula
AU - Arroja, Bruno
AU - Carvalho, Liliana
AU - Torres, Joana
AU - Santiago, Mafalda
AU - Estevinho, Maria Manuela
AU - Danese, Silvio
AU - Peyrin-Biroulet, Laurent
AU - Dias, Cláudia Camila
AU - Borralho, Paula
AU - Feakins, Roger M.
AU - Carneiro, Fátima
N1 - Publisher Copyright:
© 2021 AGA Institute
PY - 2021/12
Y1 - 2021/12
N2 - Background & Aims: In addition to findings from endoscopy, histologic features of colon biopsies have been associated with outcomes of patients with ulcerative colitis (UC). We investigated associations between Geboes scores (a system to quantify structural changes and inflammatory activity in colon biopsies) and UC progression, and the time period over which this association is valid. Methods: We analyzed data from 399 asymptomatic patients with UC enrolled in the ACERTIVE study, followed at 13 inflammatory bowel disease (IBD) centers in Portugal through 31 December 2019. Blood and stool samples were collected and analyzed, and all patients underwent sigmoidoscopy within 24 h of sample collection. We assessed baseline endoscopic status (Mayo endoscopic subscore), histologic features of 2 sigmoid and 2 rectal biopsies (Geboes score), and concentration of fecal calprotectin (FC). The primary outcome was UC progression (surgical, pharmacologic, and clinical events). We generated survival curves for 36 months or less and more than 36 months after biopsy according to Geboes score using the Kaplan-Meier method and compared findings with those from a log rank test. Cox regression was adjusted for Mayo endoscopic subscore, Geboes score, and level of FC; results were expressed as adjusted hazard ratios (HR) with 95% CIs. Results: Patients with Geboes scores >2B.0, Geboes scores >3.0, or Geboes scores >4.0 had a higher frequency of, and a shorter time to UC progression, than patients with Geboes scores ≤2B.0, Geboes scores ≤3.0, or Geboes score ≤4.0 (P < .001). Disease progression occurred earlier in patients with Geboes scores >2B.0, Geboes scores >3.0, or Geboes scores >4.0 compared with patients with Geboes scores ≤2B.0 (HR, 2.021; 95% CI, 1.158–3.526), Geboes scores ≤3.0 (HR, 2.007; 95% CI, 1.139–3.534), or Geboes scores ≤4.0 (HR, 2.349; 95% CI, 1.269–4.349), respectively, in the first 36 months after biopsy. Similar results were found for patients with concentrations of FC below 150 μg/g. Conclusions: We found histologic features of colon biopsies (Geboes score) to be an independent risk factor for progression of UC in the first 36 months after biopsy.
AB - Background & Aims: In addition to findings from endoscopy, histologic features of colon biopsies have been associated with outcomes of patients with ulcerative colitis (UC). We investigated associations between Geboes scores (a system to quantify structural changes and inflammatory activity in colon biopsies) and UC progression, and the time period over which this association is valid. Methods: We analyzed data from 399 asymptomatic patients with UC enrolled in the ACERTIVE study, followed at 13 inflammatory bowel disease (IBD) centers in Portugal through 31 December 2019. Blood and stool samples were collected and analyzed, and all patients underwent sigmoidoscopy within 24 h of sample collection. We assessed baseline endoscopic status (Mayo endoscopic subscore), histologic features of 2 sigmoid and 2 rectal biopsies (Geboes score), and concentration of fecal calprotectin (FC). The primary outcome was UC progression (surgical, pharmacologic, and clinical events). We generated survival curves for 36 months or less and more than 36 months after biopsy according to Geboes score using the Kaplan-Meier method and compared findings with those from a log rank test. Cox regression was adjusted for Mayo endoscopic subscore, Geboes score, and level of FC; results were expressed as adjusted hazard ratios (HR) with 95% CIs. Results: Patients with Geboes scores >2B.0, Geboes scores >3.0, or Geboes scores >4.0 had a higher frequency of, and a shorter time to UC progression, than patients with Geboes scores ≤2B.0, Geboes scores ≤3.0, or Geboes score ≤4.0 (P < .001). Disease progression occurred earlier in patients with Geboes scores >2B.0, Geboes scores >3.0, or Geboes scores >4.0 compared with patients with Geboes scores ≤2B.0 (HR, 2.021; 95% CI, 1.158–3.526), Geboes scores ≤3.0 (HR, 2.007; 95% CI, 1.139–3.534), or Geboes scores ≤4.0 (HR, 2.349; 95% CI, 1.269–4.349), respectively, in the first 36 months after biopsy. Similar results were found for patients with concentrations of FC below 150 μg/g. Conclusions: We found histologic features of colon biopsies (Geboes score) to be an independent risk factor for progression of UC in the first 36 months after biopsy.
KW - Biomarker
KW - Colonoscopy
KW - Fecal
KW - Prognostic factor
UR - http://www.scopus.com/inward/record.url?scp=85104310448&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2020.09.017
DO - 10.1016/j.cgh.2020.09.017
M3 - Article
C2 - 32920215
AN - SCOPUS:85104310448
SN - 1542-3565
VL - 19
SP - 2567-2576.e9
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 12
ER -
