Objective Both endoscopy and histology may be included in the definition of mucosal healing in UC. This study aimed to establish the association between patient-reported outcomes, specifically symptom measures, and the presence of inflammation as measured by endoscopy and histology in UC. Design Using patient data from an observational multicentre study of UC (n=103), rectal bleeding (RB) and stool frequency (SF) symptom subscores of the Mayo Clinic Score (MCS) were compared with the endoscopic subscore (MCSe) and histology. Faecal calprotectin and biopsy cytokine expression were also evaluated. Results When identifying UC patients with inactive disease, RB scores were superior to SF scores and the combination (sensitivity/specificity: MCSe=0/1, RB 77%/81%, SF 62%/95%, RB+SF 54%/95%; MCSe=0, RB 87%/66%, SF 76%/83%, RB+SF 68%/86%). Across different definitions of mucosal healing (MCSe≤1; 0; or 0 plus inactive histology), a larger subset of patients reported increased SF (39%, 25% and 27%, respectively) compared with RB (24%, 13% and 10%). Faecal calprotectin and inflammatory cytokine expression were higher in patients with active disease compared with patients with mucosal healing, but there were no differences between patients using increasingly stringent definitions of mucosal healing. Conclusions Endoscopically inactive disease is associated with absence of RB but not with complete normalisation of SF. Achieving histological remission did not improve symptomatic relief. In addition, in these patients, higher inflammatory biomarker levels were not observed. These data suggest that non-inflammatory changes, such as bowel damage, may contribute to SF in UC.

中文翻译：

---

UC 患者报告的结果与内窥镜和组织学外观之间的差异

目的 UC 黏膜愈合的定义可以包括内镜和组织学。本研究旨在建立患者报告的结果（特别是症状测量）与内窥镜检查和组织学测量的 UC 炎症之间的关联。设计 使用来自 UC（n=103）的观察性多中心研究的患者数据，将梅奥诊所评分 (MCS) 的直肠出血 (RB) 和大便频率 (SF) 症状子评分与内窥镜子评分 (MCSe) 和组织学进行比较。还评估了粪便钙卫蛋白和活检细胞因子的表达。结果 鉴别非活动性UC患者时，RB评分优于SF评分及其组合（敏感性/特异性：MCSe=0/1，RB 77%/81%，SF 62%/95%，RB+SF 54%/ 95%；MCSe=0，RB 87%/66%，SF 76%/83%，RB+SF 68%/86%）。在粘膜愈合的不同定义中（MCSe≤1；0；或 0 加上非活动组织学），与 RB（分别为 24%、13% 和10%）。与粘膜愈合患者相比，活动期疾病患者的粪便钙卫蛋白和炎性细胞因子表达更高，但使用越来越严格的粘膜愈合定义的患者之间没有差异。结论 内镜下非活动性疾病与 RB 的缺失有关，但与 SF 的完全正常化无关。实现组织学缓解并没有改善症状缓解。此外，在这些患者中，没有观察到更高的炎症生物标志物水平。这些数据表明，非炎症性变化，如肠道损伤，可能导致 UC 中的 SF。