Bálint Anita, Farkas Klaudia, Szepes Zoltán, Nagy Ferenc, Szűcs Mónika, Tiszlavicz László, Bor Renáta, Milassin Ágnes, Rutka Mariann, Fábián Anna, Molnár Tamás
First Department of Medicine, University of Szeged, H6720, Korányi fasor 8-10, Szeged, 6720, Hungary.
Department of Medical Physics and Informatics, University of Szeged, Korányi fasor 9, Szeged, 6720, Hungary.
BMC Gastroenterol. 2018 Jan 8;18(1):7. doi: 10.1186/s12876-017-0725-3.
Colonoscopy plays crucial role in the establishment of the diagnosis, management and follow-up of ulcerative colitis (UC). None of the currently widely used endoscopic scores consider disease extent, and therefore do not correlate with the real severity of UC. Our aim was to assess the accuracy of a new score, the Pancolonic Modified Mayo Score that can reflect not only the severity, but the extent of active UC.
One hundred and four UC patients were enrolled in this prospective study. The Endoscopic Mayo Scores of the involved area of the five colorectal segments were added; furthermore, the sum was multiplied by 3 in case of eMayo ≥2 (range 0 [normal] to 45 [most severe]) to obtain the Pancolonic Modified Mayo Score (panMayo) in order to clearly distinguish the active and inactive disease. We analysed the correlation of panMayo Score with eMayo and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and complicated disease outcome. We compared the endoscopic indices with serum and faecal inflammatory parameters and Riley Score.
The panMayo Score correlated with eMayo and UCEIS. Every endoscopic score showed correlation with Riley Score, CRP, haemoglobin, haematocrit, serum iron, faecal MMP-9 and calprotectin and also predicted a complicated disease outcome. Only panMayo score correlated exclusively with the extent of UC.
We suggest that this new score gives additional information about disease extent besides disease activity with a strong correlation with laboratory parameters of inflammation and with the other widely used endoscopic indices.
结肠镜检查在溃疡性结肠炎（UC）的诊断、管理及随访中发挥着关键作用。目前广泛使用的内镜评分均未考虑疾病范围，因此与UC的实际严重程度不相关。我们的目的是评估一种新的评分——全结肠改良梅奥评分的准确性，该评分不仅能反映活动性UC的严重程度，还能反映其范围。
104例UC患者纳入了这项前瞻性研究。将五个结直肠段受累区域的内镜梅奥评分相加；此外，如果内镜梅奥评分（eMayo）≥2（范围为0[正常]至45[最严重]），则将总和乘以3以获得全结肠改良梅奥评分（panMayo），以便明确区分疾病的活动期和非活动期。我们分析了panMayo评分与eMayo、溃疡性结肠炎内镜严重程度指数（UCEIS）及疾病复杂结局的相关性。我们将内镜指标与血清和粪便炎症参数以及莱利评分进行了比较。
panMayo评分与eMayo和UCEIS相关。每个内镜评分均与莱利评分、CRP、血红蛋白、血细胞比容、血清铁、粪便基质金属蛋白酶-9和钙卫蛋白相关，并且还可预测疾病复杂结局。只有panMayo评分仅与UC的范围相关。
我们认为，这个新评分除了能反映疾病活动度外，还能提供有关疾病范围的额外信息，且与炎症实验室参数以及其他广泛使用的内镜指标密切相关。
