External validation of The Paddington International Virtual Electronic Chromoendoscopy Score as a good endoscopic score to define mucosal healing and predict long-term clinical outcomes in ulcerative colitis

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Ruan, Ge Chong
Jin, Xin
Zhou, Wei Xun
You Y
Iacucci, Marietta
Ghosh, Subrata
Gui, Xian Yong
Li, Ji
Qian, Jia Ming
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Aims: To define endoscopic and histological remission in ulcerative colitis accurately, several score systems have been established. A novel Paddington International Virtual ChromoendoScopy ScOre (PICaSSO) virtual electronic chromoendoscopy (VEC) was recently developed, validated, and reproduced to assess inflammation grade and predict prognosis. We externally verified and validated the clinical value of the PICaSSO score in UC patients. Methods: This prospective study enrolled 63 UC patients. The Mayo Endoscopic Score (MES), UC Endoscopic Index of Severity (UCEIS), and PICaSSO score were adopted for endoscopic evaluation. All biopsies were scored using the Robarts Histological Index (RHI), Nancy Histological Index (NHI), and Extent, Chronicity, Activity, and additional findings (ECAP). Patients with an endoscopic MES of 0-1 at baseline were followed up with the median time of 23.5 months. Results: PICaSSO was strongly correlated with other endoscopic and histological scores. PICaSSO ≤3 had advantages in assessing histological remission (HR), with the highest accuracy of 88.9% for ECAP-HR. Relapse-free survival rates were significantly different between patients with MES 0 and MES 1 and patients with PICaSSO ≤3 vs>3 (P = 0.010 and 0.018, respectively). Conclusions: PICaSSO was externally validated with strong correlations with other endoscopic and histopathologic scoring systems in UC, and PICaSSO-ER might potentially predict the better long-term clinical outcomes in UC patients.
Clinical outcomes , Endoscopic remission , Histological remission , Ulcerative colitis , Virtual electronic chromoendoscopy
Ruan, G.C., Jin, X., Zhou, W.X., You, Y., Iacucci, M., Ghosh, S., Gui, X.Y., Li, J. and Qian, J.M. (2022) ‘External validation of the paddington international virtual electronic chromoendoscopy score as a good endoscopic score to define mucosal healing and predict long‐term clinical outcomes in ulcerative colitis’, Journal of Digestive Diseases, pp. 1751-2980.13126. doi: 10.1111/1751-2980.13126
© 2022 Wiley. This is the peer reviewed version of the following article. (2022), External Validation of The Paddington International Virtual Electronic Chromoendoscopy Score As A Good Endoscopic Score to Define Mucosal Healing and Predict Long-term Clinical Outcomes in Ulcerative Colitis. J Dig Dis. Accepted Author Manuscript, which has been published in final form at https://doi.org/10.1111/1751-2980.13126. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.