INFLUENCE OF THE TYPE OF MANIFESTATION OF CROHN'S DISEASE ON THE CORRELATION BETWEEN CLINICAL, ENDOSCOPIC, AND HISTOLOGICAL INDICES

Introduction Crohn's Disease (CD) can affect any part of the gastrointestinal tract. It is influenced by environmental, genomic, microbial, and immunological factors. The goal of therapy is to keep patients asymptomatic, but 40% of patients in clinical remission still show endoscopic activity. Currently, endoscopic remission is the desired target, with discussions about histological remission as the ultimate goal. The correlation between clinical, endoscopic, and histological scores has not yet been clearly established.

Methods Thirty-five patients participated in a cross-sectional study from January 2020 to 2022. Clinical activity was assessed using the Crohn's Disease Activity Index (CDAI), endoscopic activity was assessed using the Simplified Endoscopic Score for Crohn's Disease (SES-CD), and histological activity was assessed using the Global Histological Activity Score (GHAS). Clinical remission was defined as CDAI ≤ 150, endoscopic remission as SES-CD ≤ 2, and histological remission as GHAS ≤ 4.

Discussion In the study, clinical remission was observed in 34.1% of cases, endoscopic remission in 39%, and histological remission in 22%. Statistical analysis showed a strong correlation between SES-CD and GHAS in the Montreal classification L2 phenotype (r = 0.73; p = 0.001). These results suggest that combining endoscopic and histological data provides a more comprehensive view of disease activity. Residual histological inflammation may influence therapeutic strategy, indicating the importance of integrated evaluation. Studies suggest that histological activity is an important prognostic indicator, especially in cases with persistent mucosal inflammation. Recent clinical trials recommend including endoscopic and histological data for a more effective treatment approach.

Conclusion The study has limitations, including a heterogeneous population, extremes of age, variable treatment duration, and a small sample size, but statistical parameters were preserved. The results show a strong positive relationship between endoscopic and histological findings in the L2 region. Combining endoscopic and histological data provides a more complete view of disease activity, assisting in more accurate and effective therapeutic strategies. Future research should focus on larger and more homogeneous samples with standardized biopsy protocols to improve the quality of life for patients with CD and reduce the morbidity associated with the disease.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025