INTRODUCTION We aimed to evaluate the reliability and validity of the Ulcerative Colitis (UC) Endoscopic Index of Severity (UCEIS) and Mayo Endoscopy Score (MES) and to validate the Robarts Histopathology Index (RHI) and Nancy Index (NI) in pediatric UC. We examined rectosigmoid and pancolonic versions of each instrument. METHODS Single-center cross-sectional study of 60 prospectively enrolled participants. Through central endoscopy review, 4 pediatric gastroenterologists assigned rectosigmoid and pancolonic (mean of 5 colonic segments) UCEIS and MES scores. Two blinded pathologists assigned rectosigmoid and pancolonic RHI and NI scores. We assessed reliability with intraclass correlation coefficients and weighted kappa statistics and explored construct validity with correlations, boxplots, and receiver operator characteristic curves. RESULTS The UCEIS and MES displayed almost perfect intra-rater and inter-rater reliability (intraclass correlation coefficient and weighted kappa ≥0.85), moderate-to-strong correlation with histologic/clinical activity and fecal calprotectin (FC), and very strong correlation with global endoscopic severity (r > 0.9). Rectosigmoid UCEIS and MES scores of 0 were highly specific (≥95%) for endoscopic and histologic remission throughout the colon. Pancolonic endoscopy scores correlated more strongly with histologic activity, clinical activity, and systemic inflammatory markers and better discriminated between degrees of active disease. RHI and NI showed moderate-to-strong correlation (r = 0.5-0.83) with endoscopic/clinical activity and FC. DISCUSSION Our findings support the reliability and construct validity of the UCEIS and MES and the construct validity of the RHI and NI in pediatric UC. Normal rectosigmoid findings predicted pancolonic healing, but, given active disease, pancolonic endoscopic assessment more accurately captured global disease burden.

中文翻译：

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使用集中审查对小儿溃疡性结肠炎的内镜和组织学指标进行前瞻性评估。

引言 我们旨在评估溃疡性结肠炎 (UC) 内镜严重程度指数 (UCEIS) 和梅奥内镜评分 (MES) 的可靠性和有效性，并验证儿童 UC 中的 Robarts 组织病理学指数 (RHI) 和 Nancy 指数 (NI)。我们检查了每种仪器的 rectosigmoid 和 pancolonic 版本。方法 对 60 名前瞻性登记的参与者进行的单中心横断面研究。通过中央内窥镜检查，4 名儿科胃肠病学家分配了直肠乙状结肠和全结肠（5 个结肠段的平均值）UCEIS 和 MES 评分。两名不知情的病理学家分配了直肠乙状结肠和全结肠 RHI 和 NI 评分。我们使用组内相关系数和加权 kappa 统计来评估可靠性，并使用相关性、箱线图和接受者操作特征曲线探索结构有效性。结果 UCEIS 和 MES 显示出几乎完美的评分者内和评分者间可靠性（组内相关系数和加权 kappa ≥0.85），与组织学/临床活性和粪便钙卫蛋白 (FC) 中度至强相关，与整体内窥镜严重程度（r > 0.9）。直肠乙状结肠 UCEIS 和 MES 评分为 0 对整个结肠的内镜和组织学缓解具有高度特异性 (≥95%)。Pancolonic 内窥镜评分与组织学活动、临床活动和全身炎症标志物的相关性更强，并且能更好地区分活动性疾病的程度。RHI 和 NI 与内窥镜/临床活动和 FC 显示出中到强的相关性 (r = 0.5-0.83)。讨论 我们的研究结果支持 UCEIS 和 MES 的可靠性和结构效度以及 RHI 和 NI 在儿科 UC 中的结构效度。正常的直肠乙状结肠检查结果可以预测全结肠愈合，但是，考虑到活动性疾病，全结肠内镜评估更准确地捕捉到了整体疾病负担。