Article Dans Une Revue Clinical Gastroenterology and Hepatology Année : 2020

Nancy Index Scores of Chronic Inflammatory Bowel Disease Activity Associate With Development of Colorectal Neoplasia

Julien Kirchgesner
Magali Svrcek
  • Fonction : Auteur
Guillaume Le Gall
  • Fonction : Auteur
Cécilia Landman
  • Fonction : Auteur
Xavier Dray
Anne Bourrier
  • Fonction : Auteur
Isabelle Nion-Larmurier
  • Fonction : Auteur
Nadia Hoyeau
  • Fonction : Auteur
Harry Sokol
Philippe Seksik
Jacques Cosnes
  • Fonction : Auteur
Jean-François Fléjou
  • Fonction : Auteur
Laurent Beaugerie
  • Fonction : Auteur

Résumé

Background & Aims. The degree of histologic and endoscopic disease activity has been associated with an increased risk of colorectal neoplasia (CRN) in patients with inflammatory bowel diseases (IBDs), but no histologic scoring systems have been validated for determining risk of CRN. We investigated the association between histologic and endoscopic disease activity and risk of first CRN in patients with IBD who had negative findings from a surveillance colonoscopy. Methods. We performed a retrospective analysis of consecutive patients who underwent at least 2 colonoscopies at Saint Antoine Hospital in France from January 1, 1996, through March 1, 2015, and whose first procedure was a surveillance colonoscopy. Histologic IBD activity was assessed by the Nancy histologic index. Patients were followed up for a mean 5.7 ± 3.3 years. Logistic regression and generalized estimating equations were used to identify clinical, endoscopic, and histologic factors associated with detection of neoplasia in the inflamed colon mucosa. Results. Among 398 patients who underwent 1277 colonoscopies, we identified 45 patients with CRN. Factors associated with CRN were primary sclerosing cholangitis (odds ratio [OR], 2.65; 95% CI, 1.06–6.61; P = .04), age (OR per 1-year increase, 1.04; 95% CI, 1.01–1.07; P = .003), and mean Nancy histologic index during follow-up evaluation (per 1-unit increase, OR, 1.69; 95% CI, 1.29–2.21; P < .001). After adjustment for established factors, chronic disease activity defined as detection of ulcerations at more than 50% of colonoscopies was not associated with an increased risk of CRN (OR, 1.24; 95% CI, 0.53–2.91; P = .62). Conclusions. In addition to established risk factors, we associated Nancy histologic index scores with development of CRN. Histologic findings based on the Nancy histologic index therefore should be included in determining the risk of colonic neoplasia in patients with IBD.

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hal-03347328 , version 1 (17-09-2021)

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Julien Kirchgesner, Magali Svrcek, Guillaume Le Gall, Cécilia Landman, Xavier Dray, et al.. Nancy Index Scores of Chronic Inflammatory Bowel Disease Activity Associate With Development of Colorectal Neoplasia. Clinical Gastroenterology and Hepatology, 2020, 18 (1), pp.150-157.e1. ⟨10.1016/j.cgh.2019.05.002⟩. ⟨hal-03347328⟩
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