*Department of Medicine, Western University, London, Ontario, Canada; †Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; ‡Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada; §Robarts Clinical Trials, Inc., Robarts Research Institute, Western University, London, Ontario, Canada; ‖Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; ¶Division of Gastroenterology, University of California San Diego, La Jolla, California; **Department of Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands; ††Pacific Rim Pathology Medical Corporation, San Diego, California; ‡‡Carolinas Medical Center, Charlotte, North Carolina; §§Department of Pathology, Western University, London, Ontario, Canada; and ‖‖Department of Pathology, University Hospital of KU Leuven, Leuven, Belgium.
Inflamm Bowel Dis. 2014 Mar;20(3):564-75. doi: 10.1097/01.MIB.0000437986.00190.71.
Ulcerative colitis (UC) is an idiopathic inflammatory disorder. Currently, the main goals of treatment are to induce and maintain clinical and/or endoscopic remission. However, evidence indicates that persistent disease activity on colonic biopsies in the setting of clinical or endoscopic remission is an independent predictor of poor outcomes. A number of previous studies have proposed histologic indices for use in specific trials of UC. The aim of this study was to systematically review the existing histological indices for UC and assess their potential use in both patient management and clinical trials.
We performed a systematic review of histological indices evaluating disease activity in UC. MEDLINE (Ovid), EMBASE (Ovid), PubMed, the Cochrane Library (CENTRAL), and Digestive Diseases Week (DDW) abstracts of randomized and/or controlled trials clinical trials were searched from inception to February 2013 for applicable studies. Data from these studies were reviewed and analyzed.
After systematically applying inclusion criteria, we identified 108 scientific articles including 88 clinical studies and 21 related clinical reviews. Eighteen indices of histological activity in UC were identified and reviewed.
Although multiple histological scoring indices for assessment of UC disease activity currently exist, none of these instruments were developed using a formal validation process and their operating properties remain poorly understood. Future studies are needed to address this deficiency.
溃疡性结肠炎（UC）是一种特发性炎症性疾病。目前，治疗的主要目标是诱导和维持临床和/或内镜缓解。然而，有证据表明，在临床或内镜缓解的情况下结肠活检中持续的疾病活动是不良结局的独立预测因子。先前的许多研究已经提出了用于 UC 特定试验的组织学指标。本研究的目的是系统地回顾现有的 UC 组织学指标，并评估其在患者管理和临床试验中的潜在用途。
我们对评估 UC 疾病活动的组织学指标进行了系统评价。从创建到 2013 年 2 月，我们在 MEDLINE（Ovid）、EMBASE（Ovid）、PubMed、Cochrane 图书馆（CENTRAL）和消化疾病周（DDW）的随机和/或对照临床试验摘要中搜索了适用的研究。对这些研究的数据进行了回顾和分析。
经过系统地应用纳入标准，我们确定了 108 篇科学文章，包括 88 项临床研究和 21 项相关临床综述。确定并回顾了 18 种 UC 组织学活动指标。
虽然目前存在多种用于评估 UC 疾病活动的组织学评分指标，但这些指标均未通过正式验证过程开发，其操作特性仍知之甚少。需要进一步的研究来解决这一不足。
