Evaluation of Mayo endoscopic subscore in ulcerative colitis with concomitant primary sclerosing cholangitis

Abstract

This article relates to the discussion of a recent study published by Wohl et al. Primary sclerosing cholangitis (PSC) is a chronic inflammatory liver disease that affects the intra- and extrahepatic bile ducts and is strongly associated with ulcerative colitis (UC). Endoscopic evaluation of UC is feasible and reliable in routine clinical practice, and the Mayo endoscopic subscore (MES) is one of the most commonly used endoscopic evaluation measures for UC. Patients with PSC-UC are at higher risk of developing cancer and biliary tract cancer. Endoscopic scoring alone appears unreliable, and histopathological evaluation is essential to accurately assess and make effective therapeutic decisions for PSC-UC. Therefore, we aimed to discuss the accuracy of MES in patients with UC and PSC-UC and to explore the consistency between MES and the Nancy histological index.

Keywords: Primary sclerosing cholangitis; Ulcerative colitis; Diagnosis; Mayo endoscopic subscore; Nancy histological index

Core Tip: Patients with ulcerative colitis and primary sclerosing cholangitis have a high risk of colonic neoplasia and are more likely to have pancolitis, backwash ileitis, and rectal sparing. Both endoscopic and histological inflammation evaluation are important for the diagnosis and treatment of ulcerative colitis with concomitant primary sclerosing cholangitis. Therefore, this study aimed to explore the consistency between endoscopic and histological evaluation.