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Mayo Endoscopic Score (MES) as a reference for the histological active disease of ulcerative colitis

  • Agung Ary Wibowo ,
  • Hendy Buana Vijaya ,
  • Didik Dwi Sanyoto ,
  • Hendra Sutapa ,
  • Husna Dharma Putera ,
  • Kenanga Marwan Sikumbang ,


Background: The degree of inflammation dramatically affects the morbidity of ulcerative colitis. Local and systemic inflammation features are modalities to determine disease severity and evaluation. Furthermore, local inflammation can be seen from endoscopic and histological examinations. This study aimed to examine the relationship of histological inflammatory profile with endoscopic scoring in ulcerative colitis patients.

Method: A retrospective study was conducted using colonoscopic and histologic data from 68 ulcerative colitis patients. The endoscopic grade was assessed based on the Mayo Endoscopic Score (MES). The histological grade was analyzed using a microscope by assessing acute and chronic inflammatory cells and the presence of ulceration and crypt changes based on the Nancy Score Index and Geboes Score Index. Furthermore, the analysis test used Spearman and Mann-Whitney.

Results: There is a significant positive relationship between endoscopic and histology scoring. The Nancy Score Index and MES combination yields 95% CI: 0.000-0.043, p=0.000, Correlation coefficient (r)=0.810, and odds ratio (OR)=3.272. Meanwhile, the combination of the Geboes Score Index with MES yields 95% CI: 0.000-0.043; p=0.000; r=0.727; and OR=1.347. In each histological scoring, there was a significant difference between the Nancy Score Index and Geboes Score Index tα (r = 0.018; p<0.05).

Conclusion: There is a significant relationship between histological and endoscopic scoring. Therefore, an endoscopic examination can be a reference for histologically active disease.


  1. Sheng YH, Hasnain SZ, Florin THJ, McGuckin MA. Mucins in inflammatory bowel diseases and colorectal cancer. J Gastroenterol Hepatol. 2012;27(1):28-38.
  2. Wolff BG. Ulcerative Colitis. Clin Colon Rectal Surg. 2004;17(1):3.
  3. Kucharzik T, Koletzko S, Kannengießer K, Dignaß A. Colitis ulcerosa - Diagnostische und therapeutische Algorithmen. Dtsch Arztebl Int. 2020;117(33-34):564-573.
  4. Molnar T. Pathogenesis of Ulcerative Colitis and Crohn’s Disease: Similarities, Differences and a Lot of Things We Do Not Know Yet. J Clin Cell Immunol. 2014;5(4):1-15.
  5. Xu W, Liu F, Tang W, et al. The Mayo Endoscopic Score Is a Novel Predictive Indicator for Malignant Transformation in Ulcerative Colitis: A Long-Term Follow-Up Multicenter Study. Front Surg. 2022;9:1-9.
  6. Sharara AI, Malaeb M, Lenfant M, Ferrante M. Assessment of Endoscopic Disease Activity in Ulcerative Colitis: Is Simplicity the Ultimate Sophistication? Inflamm Intest Dis. 2022;7(1):7-12.
  7. Shah J, Dutta U, Das A, et al. Relationship between Mayo endoscopic score and histological scores in ulcerative colitis: A prospective study. JGH Open. 2020;4(3):382-386.
  8. Kim DB, Lee KM, Lee JM, et al. correlation between histological activity and endoscopic, clinical, and serologic activities in patients with ulcerative colitis. Gastroenterol Res Pract. 2016;2016:1-8.
  9. Tontini GE, Bisschops R, Neumann H. Endoscopic scoring systems for inflammatory bowel disease: Pros and cons. Expert Rev Gastroenterol Hepatol. 2014;8(5):543-554.
  10. Fluxá D, Simian D, Flores L, Ibáñez P, Lubascher J, et al. Clinical, endoscopic and histological correlation and measures of association in ulcerative colitis. J Dig Dis. 2017;18(11):634-641.
  11. Purnamaningsih SM. Serum markers of Inflammatory Bowel Disease: A literature review. Bali Medical Journal. 2018;7(2):491-498.
  12. Sharara AI, Malaeb M, Lenfant M, Ferrante M. Assessment of Endoscopic Disease Activity in Ulcerative Colitis: Is Simplicity the Ultimate Sophistication? Inflamm Intest Dis. 2022;7(1):7-12.
  13. Marchal Bressenot A, Riddell RH, Boulagnon-Rombi C, et al. Review article: The histological assessment of disease activity in ulcerative colitis. Aliment Pharmacol Ther. 2015;42(8):957-967.
  14. Jauregui-amezaga A, Geerits A, Das Y, et al.Original Article A Simplified Geboes Score for Ulcerative Colitis. Journal of Crohn's and Colitis. 2017:11(3);305-313.
  15. Lang-Schwarz C, Rubio CA, Vieth M. Diagnostic Impact of Crypt Branching in Patients With Crohn’s Disease: A Validation Study. Anticancer Res. 2022;42(4):1919-1923.
  16. Kirchgesner J, Svrcek M, Gall G Le, et al. Nancy Index Scores of Chronic Inflammatory Bowel Disease Activity Associate With Development of Colorectal Neoplasia. Clin Gastroenterol Hepatol. 2020;18:150-157.
  17. Ungaro R, Colombel JF, Lissoos T, Peyrin-Biroulet L. A Treat-to-Target Update in Ulcerative Colitis: A Systematic Review. Am J Gastroenterol. 2019;114(6):874-883.
  18. Prabawa IPY, Bhargah A, Liwang F, Tandio DA, Tandio AL, Lestari AAW, Budiana ING, Manuaba IBAP. Pretreatment Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as a Predictive Value of Hematological Markers in Cervical Cancer. Asian Pac J Cancer Prev. 2019;20(3):863-868.

How to Cite

Wibowo, A. A., Vijaya, H. B., Sanyoto, D. D., Sutapa, H., Putera, H. D., & Sikumbang, K. M. (2023). Mayo Endoscopic Score (MES) as a reference for the histological active disease of ulcerative colitis. Bali Medical Journal, 12(1), 340–344.




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Agung Ary Wibowo
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BMJ Journal

Hendy Buana Vijaya
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Didik Dwi Sanyoto
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Hendra Sutapa
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Husna Dharma Putera
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Kenanga Marwan Sikumbang
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BMJ Journal