Endocytoscopy in real-time assessment of histological and endoscopic activity in ulcerative colitis

Table 1 Characteristics of evaluated colonic segments in ulcerative colitis cohort, n (%)

Characteristics	Value
Male	8 (53.3)
Age (mean ± SD)	41.3 ± 10.6
Clinical remission (partial Mayo score < 2)	11 (73.3)
Assessment sites	61 (100)
Cecum	4 (6.6)
Ascending colon	10 (16.4)
Transverse colon	11 (18.0)
Descending colon	11 (18.0)
Sigmoid	15 (24.6)
Rectum	10 (16.4)
Mayo endoscopic score
0 (endoscopic remission)	41 (67.2)
1	1 (1.6)
2	13 (21.3)
3	6 (9.8)
Endocytoscopy scores
Endocytoscopy score (0-6), median (IQR)	2 (0-4)
Crypt shape (0-3)	1 (0-1)
Crypt distance (0-2)	0 (0-1)
Small vessels (0-1)	1 (0-1)
Endocytoscopy scores remission (< 1)	31 (50.8)
ErLangen Endocytoscopy in ColiTis (0-6), median (IQR)	1 (0-4)
Crypt shape (0-2)	1 (0-1)
Crypt distance (0-1)	0 (0-1)
Vascular architecture (0-1)	0 (0-1)
Inflammatory cell infiltrate (0-1)	0 (0-1)
Crypt abscess (0-1)	0 (0-0)
ErLangen Endocytoscopy in ColiTis remission (< 2)	42 (68.9)
Nancy histological index (0-4)	0 (0-3)
0 (histological remission)	41 (67.2)
1	3 (4.92)
2	3 (4.92)
3	8 (13.1)
4	6 (9.84)

IQR: Interquartile range.

Table 2 Overview of endocytoscopy score and ErLangen Endocytoscopy in ColiTis scoring systems by subscore

Endocytoscopy score	n (%)	ErLangen Endocytoscopy in ColiTis score	n (%)
Crypt shape		Crypt shape
Normal (0)	28 (45.9)	Round/oval (0)	31 (50.8)
Oval/possible distortion (1)	19 (31.1)	Irregular, distorted (1)	18 (29.5)
Irregular/severe distortion (2)	7 (11.5)	Disruption/loss of crypts (2)	12 (19.7)
Unclear/not recognized (3)	7 (11.5)	Crypt distance
Crypt distance		< 2 crypt diameter (0)	44 (72.1)
> 3 crypts in a visual field (0)	7 (11.5)	> 2 crypt diameter (1)	17 (27.9)
2 < crypts < 3 in a visual field (1)	43 (70.5)	Vascular architecture
Elongated, < 2 crypts in a visual field (2)	9 (14.8)	Normal: Round and small caliber (0)	40 (65.6)
Small vessels		Distorted: Tortuous, dilated, erythrocyte leakage (1)	21 (34.4)
Not visible (0)	22 (36.1)	Inflammatory cell infiltrate
Visible (1)	39 (63.9)	Absent (0)	44 (72.1)
		Present (1)	17 (27.9)
		Crypt abscess
		Absent (0)	61 (100)
		Present (1)	0 (0)

Table 3 Endoscopic, endocytoscopic, histological response, and remission according to each colonic segment, n (%)

	Endoscopic remission (MES = 0)	ECSS remission (< 1)	ELECT remission (< 2)	Histological response (NHI < 1)	Histological remission (NHI = 0)
Cecum (n = 4)	3 (75)	3 (75)	3 (75)	3 (75)	3 (75)
Ascending colon (n = 9)	9 (90)	7 (70)	9 (90)	9 (90)	9 (90)
Transverse colon (n = 12)	9 (81.8)	7 (63.6)	9 (81.8)	9 (81.8)	7 (63.6)
Descending colon (n = 11)	10 (90.9)	6 (54.6)	10 (90.9)	10 (90.9)	10 (90.9)
Sigmoid (n = 15)	8 (53.3)	6 (40)	9 (60)	9 (60)	9 (60)
Rectum (n = 10)	2 (20)	2 (20)	4 (40)	4 (40)	3 (30)

MES: Mayo endoscopic score; ECSS: Endocytoscopy score; ELECT: ErLangen Endocytoscopy in ColiTis score; NHI: Nancy histological index.

Table 4 Correlation between endocytoscopy scores and endoscopic/histological score

Correlation	Spearman’s rho	P value	Kappa1	P value
MES vs ECSS	0.78	< 0.001	0.60	< 0.001
MES vs ELECT score	0.81	< 0.001	0.88	< 0.001
ECSS vs NHI	0.69	< 0.001	0.47	< 0.001
ELECT vs NHI	0.74	< 0.001	0.88	< 0.001
ECSS vs NHI
Cecum	1.0	< 0.001	1	0.02
Ascending colon	0.59	0.07	0.41	0.05
Transverse colon	0.30	0.38	0.21	0.24
Descending colon	0.53	0.10	0.21	0.12
Sigmoid	0.87	< 0.001	0.61	0.01
Rectum	0.90	< 0.001	0.21	0.25
ELECT vs NHI
Cecum	0.82	< 0.001	1	0.02
Ascending colon	0.60	0.07	1	< 0.001
Transverse colon	0.42	0.20	0.56	0.02
Descending colon	0.59	0.06	1	< 0.001
Sigmoid	0.91	< 0.001	1	< 0.001
Rectum	0.88	< 0.001	0.78	0.005

¹Kappa correlation was analyzed based on Mayo endoscopic score = 0 or endocytoscopic [(endocytoscopy score < 1) or (ErLangen Endocytoscopy in ColiTis score < 2)] remission vs histological remission (Nancy histological index = 0).

MES: Mayo endoscopic score; ECSS: Endocytoscopy score; ELECT: ErLangen Endocytoscopy in ColiTis score; NHI: Nancy histological index.