Evaluation of Simplified Geboes Score in Ulcerative Colitis

Abstract

Background: Ulcerative colitis (UC) is a chronic inflammatory disease of unknown etiology characterized by a relapsing and remitting course. Assessment of disease activity is based on combination of clinical features, endoscopic scoring and histological scoring. Over the years, Histological healing has replaced mucosal healing as the therapeutic endpoint in UC. Various histological parameters have their own significance in predicting treatment outcomes and prognosis. Many histologic scoring systems have been proposed with one such validated score being Geboes score. However, in view of its complexity to use the Simplified Geboes Score (SGS) was developed in 2016. Aim & Objectives: To assess the interobserver agreement of SGS in ulcerative colitis. Methods: This was retrospective study of 6 years duration. Relevant clinical and endoscopic details were documented. 41 cases of UC were included in the study. The SGS scoring was done by two pathologists independently. Agreement for individual grades of SGS and for the detection of Histologic activity (score >3.1) was compared between both pathologists using Cohen’s kappa coefficient. Results: Majority of the patients were in the age group of 15-72 years with male preponderance. Left sided colon was more commonly involved with loose stools being most common symptom. Cohen’s test showed moderate to good agreement for individual grades and good agreement for Histologic activity. Conclusion: The SGS is simple to use and shows good interobserver agreement for histological activity and moderate to good agreement for individual parameter. Therefore, it can be adopted for routine reporting of all biopsies in ulcerative colitis. Keywords: Histological healing, Mucosal healing, Simplified Geboes Score, Ulcerative colitis