Mosli et al developed the Robarts Histopathology Index (RHI) to describe colon biopsies from patients with ulcerative colitis (UC). The authors are from Robarts Research Institute at the University of Western Ontario plus additional institutions in Canada, the United States and Europe.
Patient selection: ulcerative colitis
Parameters:
(1) chronic inflammatory infiltrate (4 levels)
(2) lamina propria neutrophils (4 levels)
(3) neutrophils in epithelium (4 levels)
(4) erosion or ulceration (4 levels)
|
Parameter |
Finding |
Points |
Regression Model |
|
chronic inflammation |
no increase |
0 |
0 |
|
|
mild increase but unequivocal |
1 |
3.34 |
|
|
moderate increase |
2 |
6.68 |
|
|
marked increase |
3 |
10.02 |
|
lamina propria neutrophils |
none |
0 |
0 |
|
|
mild increase but unequivocal |
2 |
5.6 |
|
|
moderate incrase |
4 |
11.2 |
|
|
marked increase |
6 |
16.8 |
|
neutrophils in epithelium |
none |
0 |
0 |
|
|
< 5% crypts |
3 |
8.9 |
|
|
5-50% crypts |
6 |
17.8 |
|
|
>50% crypts |
9 |
26.7 |
|
erosions or ulcerations |
none |
0 |
0 |
|
|
recovering epithelium with adjacent inflammation |
5 |
14.92 |
|
|
probable erosion |
5 |
14.92 |
|
|
unequivocal erosion |
10 |
29.84 |
|
|
ulcer or granulation tissue |
15 |
44.76 |
where:
• The multiple for the RHI is beta-coefficient divided by 3 then rounded to an integer.
RHI =
= SUM(points for the 4 parameters)
X for the regression model =
= SUM(regression model points for the 4 parameters) - 9.62
probability of disease activity =
= 1 / (1 + EXP((-1) * X)
Interpretation:
• minimum RHI: 0
• maximum RHI: 33
• The higher the RHI the greater the activity of the UC.
• An RHI <= 6 is associated with remission.
Specialty: Gastroenterology
