Asia Pacific association of gastroenterology consensus statements on histopathological evaluation of inflammatory bowel diseases

Rupert W. Leong; Thanaboon Chaemsupaphan; Huiyu Lin; Wee Chian Lim; Choon Jin Ooi; John D. Chetwood; Ren Mao; Hsin Yun Wu; Shu Chen Wei; Govind Makharia; Vineet Ahuja; Rupa Banerjee; Raja Atreya; Julajak Limsrivilai; Satimai Aniwan; Pises Pisespongsa; Ida Hilmi; Raja Affendi Raja Ali; Wai Keung Leung; Siew C. Ng; Byong Duk Ye; Taku Kobayashi; Katsuyoshi Matsuoka; Cora Chau; Anapat Sanpavat; Chia-Tung Shun; Pavitratha Puspanathan; Richard B. Gearry; Silvio Danese; Christopher Ma; Aviv Pudipeddi; Sudarshan Paramsothy

doi:10.1177/17562848251363703

Asia Pacific association of gastroenterology consensus statements on histopathological evaluation of inflammatory bowel diseases

Rupert W. Leong^*, Thanaboon Chaemsupaphan, Huiyu Lin, Wee Chian Lim, Choon Jin Ooi, John D. Chetwood, Ren Mao, Hsin Yun Wu, Shu Chen Wei, Govind Makharia, Vineet Ahuja, Rupa Banerjee, Raja Atreya, Julajak Limsrivilai, Satimai Aniwan, Pises Pisespongsa, Ida Hilmi, Raja Affendi Raja Ali, Wai Keung Leung, Siew C. NgByong Duk Ye, Taku Kobayashi, Katsuyoshi Matsuoka, Cora Chau, Anapat Sanpavat, Chia-Tung Shun, Pavitratha Puspanathan, Richard B. Gearry, Silvio Danese, Christopher Ma, Aviv Pudipeddi, Sudarshan Paramsothy

^*Corresponding author for this work

Macquarie Medical School

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Abstract

Background: Mucosal histological activity is increasingly valued as a treatment endpoint in inflammatory bowel diseases (IBD). In the Asia Pacific region, the utility and acceptability of IBD histology as a treatment endpoint are uncertain due to the heterogeneity of IBD prevalence, resourcing and level of knowledge among practitioners. There is an opportunity to engage clinicians to harmonise histology reporting and collaborate with pathologists in this field. Objectives: We aimed to develop consensus statements through anonymous voting on histological features, processing, reporting and relevance to treatment outcomes in IBD, including ulcerative colitis (UC) and Crohn’s disease (CD). Design: The consensus document was developed through a comprehensive literature review, followed by a deliberation process among experts in the field. Methods: Representatives of the Asia Pacific Association of Gastroenterology, in collaboration with pathologists, voted anonymously in accordance with modified Delphi methodology on statements relevant to IBD and histology. Domains of interest were histological features of UC and CD, relevance to clinical management and the potential utility of artificial intelligence (AI) in grading histological disease severity. Level of evidence and recommendation grade were included in accordance with the National Health and Medical Research Council, Australia guidelines of Australia. Results: Consensus was reached on 37 out of 38 statements concerning definitions, pathology processing and reporting, scoring system and relevance to clinical outcomes. Knowledge gaps were identified with uncertainty over the role of AI. Conclusion: These consensus statements provide recommendations, with specific relevance to the Asia Pacific region, on the role of histology in IBD to harmonise its use. The statements will promote understanding and applicability in research and in the routine management of IBD.

Original language	English
Pages (from-to)	1-20
Number of pages	20
Journal	Therapeutic Advances in Gastroenterology
Volume	18
DOIs	https://doi.org/10.1177/17562848251363703
Publication status	Published - 1 Aug 2025

Bibliographical note

Copyright the Author(s) 2025. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

consensus
Crohn’s disease
histology
inflammatory bowel disease
ulcerative colitis

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Leong, R. W., Chaemsupaphan, T., Lin, H., Chian Lim, W., Ooi, C. J., Chetwood, J. D., Mao, R., Wu, H. Y., Wei, S. C., Makharia, G., Ahuja, V., Banerjee, R., Atreya, R., Limsrivilai, J., Aniwan, S., Pisespongsa, P., Hilmi, I., Raja Ali, R. A., Leung, W. K., ... Paramsothy, S. (2025). Asia Pacific association of gastroenterology consensus statements on histopathological evaluation of inflammatory bowel diseases. Therapeutic Advances in Gastroenterology, 18, 1-20. https://doi.org/10.1177/17562848251363703

@article{09cd78ee0b9848bfbe241c02925a8b3a,

title = "Asia Pacific association of gastroenterology consensus statements on histopathological evaluation of inflammatory bowel diseases",

abstract = "Background: Mucosal histological activity is increasingly valued as a treatment endpoint in inflammatory bowel diseases (IBD). In the Asia Pacific region, the utility and acceptability of IBD histology as a treatment endpoint are uncertain due to the heterogeneity of IBD prevalence, resourcing and level of knowledge among practitioners. There is an opportunity to engage clinicians to harmonise histology reporting and collaborate with pathologists in this field. Objectives: We aimed to develop consensus statements through anonymous voting on histological features, processing, reporting and relevance to treatment outcomes in IBD, including ulcerative colitis (UC) and Crohn{\textquoteright}s disease (CD). Design: The consensus document was developed through a comprehensive literature review, followed by a deliberation process among experts in the field. Methods: Representatives of the Asia Pacific Association of Gastroenterology, in collaboration with pathologists, voted anonymously in accordance with modified Delphi methodology on statements relevant to IBD and histology. Domains of interest were histological features of UC and CD, relevance to clinical management and the potential utility of artificial intelligence (AI) in grading histological disease severity. Level of evidence and recommendation grade were included in accordance with the National Health and Medical Research Council, Australia guidelines of Australia. Results: Consensus was reached on 37 out of 38 statements concerning definitions, pathology processing and reporting, scoring system and relevance to clinical outcomes. Knowledge gaps were identified with uncertainty over the role of AI. Conclusion: These consensus statements provide recommendations, with specific relevance to the Asia Pacific region, on the role of histology in IBD to harmonise its use. The statements will promote understanding and applicability in research and in the routine management of IBD.",

keywords = "consensus, Crohn{\textquoteright}s disease, histology, inflammatory bowel disease, ulcerative colitis",

author = "Leong, \{Rupert W.\} and Thanaboon Chaemsupaphan and Huiyu Lin and \{Chian Lim\}, Wee and Ooi, \{Choon Jin\} and Chetwood, \{John D.\} and Ren Mao and Wu, \{Hsin Yun\} and Wei, \{Shu Chen\} and Govind Makharia and Vineet Ahuja and Rupa Banerjee and Raja Atreya and Julajak Limsrivilai and Satimai Aniwan and Pises Pisespongsa and Ida Hilmi and \{Raja Ali\}, \{Raja Affendi\} and Leung, \{Wai Keung\} and Ng, \{Siew C.\} and Ye, \{Byong Duk\} and Taku Kobayashi and Katsuyoshi Matsuoka and Cora Chau and Anapat Sanpavat and Chia-Tung Shun and Pavitratha Puspanathan and Gearry, \{Richard B.\} and Silvio Danese and Christopher Ma and Aviv Pudipeddi and Sudarshan Paramsothy",

note = "Copyright the Author(s) 2025. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",

year = "2025",

month = aug,

day = "1",

doi = "10.1177/17562848251363703",

language = "English",

volume = "18",

pages = "1--20",

journal = "Therapeutic Advances in Gastroenterology",

issn = "1756-283X",

publisher = "SAGE Publications",

}

Leong, RW, Chaemsupaphan, T, Lin, H, Chian Lim, W, Ooi, CJ, Chetwood, JD, Mao, R, Wu, HY, Wei, SC, Makharia, G, Ahuja, V, Banerjee, R, Atreya, R, Limsrivilai, J, Aniwan, S, Pisespongsa, P, Hilmi, I, Raja Ali, RA, Leung, WK, Ng, SC, Ye, BD, Kobayashi, T, Matsuoka, K, Chau, C, Sanpavat, A, Shun, C-T, Puspanathan, P, Gearry, RB, Danese, S, Ma, C, Pudipeddi, A & Paramsothy, S 2025, 'Asia Pacific association of gastroenterology consensus statements on histopathological evaluation of inflammatory bowel diseases', Therapeutic Advances in Gastroenterology, vol. 18, pp. 1-20. https://doi.org/10.1177/17562848251363703

TY - JOUR

T1 - Asia Pacific association of gastroenterology consensus statements on histopathological evaluation of inflammatory bowel diseases

AU - Leong, Rupert W.

AU - Chaemsupaphan, Thanaboon

AU - Lin, Huiyu

AU - Chian Lim, Wee

AU - Ooi, Choon Jin

AU - Chetwood, John D.

AU - Mao, Ren

AU - Wu, Hsin Yun

AU - Wei, Shu Chen

AU - Makharia, Govind

AU - Ahuja, Vineet

AU - Banerjee, Rupa

AU - Atreya, Raja

AU - Limsrivilai, Julajak

AU - Aniwan, Satimai

AU - Pisespongsa, Pises

AU - Hilmi, Ida

AU - Raja Ali, Raja Affendi

AU - Leung, Wai Keung

AU - Ng, Siew C.

AU - Ye, Byong Duk

AU - Kobayashi, Taku

AU - Matsuoka, Katsuyoshi

AU - Chau, Cora

AU - Sanpavat, Anapat

AU - Shun, Chia-Tung

AU - Puspanathan, Pavitratha

AU - Gearry, Richard B.

AU - Danese, Silvio

AU - Ma, Christopher

AU - Pudipeddi, Aviv

AU - Paramsothy, Sudarshan

N1 - Copyright the Author(s) 2025. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2025/8/1

Y1 - 2025/8/1

N2 - Background: Mucosal histological activity is increasingly valued as a treatment endpoint in inflammatory bowel diseases (IBD). In the Asia Pacific region, the utility and acceptability of IBD histology as a treatment endpoint are uncertain due to the heterogeneity of IBD prevalence, resourcing and level of knowledge among practitioners. There is an opportunity to engage clinicians to harmonise histology reporting and collaborate with pathologists in this field. Objectives: We aimed to develop consensus statements through anonymous voting on histological features, processing, reporting and relevance to treatment outcomes in IBD, including ulcerative colitis (UC) and Crohn’s disease (CD). Design: The consensus document was developed through a comprehensive literature review, followed by a deliberation process among experts in the field. Methods: Representatives of the Asia Pacific Association of Gastroenterology, in collaboration with pathologists, voted anonymously in accordance with modified Delphi methodology on statements relevant to IBD and histology. Domains of interest were histological features of UC and CD, relevance to clinical management and the potential utility of artificial intelligence (AI) in grading histological disease severity. Level of evidence and recommendation grade were included in accordance with the National Health and Medical Research Council, Australia guidelines of Australia. Results: Consensus was reached on 37 out of 38 statements concerning definitions, pathology processing and reporting, scoring system and relevance to clinical outcomes. Knowledge gaps were identified with uncertainty over the role of AI. Conclusion: These consensus statements provide recommendations, with specific relevance to the Asia Pacific region, on the role of histology in IBD to harmonise its use. The statements will promote understanding and applicability in research and in the routine management of IBD.

AB - Background: Mucosal histological activity is increasingly valued as a treatment endpoint in inflammatory bowel diseases (IBD). In the Asia Pacific region, the utility and acceptability of IBD histology as a treatment endpoint are uncertain due to the heterogeneity of IBD prevalence, resourcing and level of knowledge among practitioners. There is an opportunity to engage clinicians to harmonise histology reporting and collaborate with pathologists in this field. Objectives: We aimed to develop consensus statements through anonymous voting on histological features, processing, reporting and relevance to treatment outcomes in IBD, including ulcerative colitis (UC) and Crohn’s disease (CD). Design: The consensus document was developed through a comprehensive literature review, followed by a deliberation process among experts in the field. Methods: Representatives of the Asia Pacific Association of Gastroenterology, in collaboration with pathologists, voted anonymously in accordance with modified Delphi methodology on statements relevant to IBD and histology. Domains of interest were histological features of UC and CD, relevance to clinical management and the potential utility of artificial intelligence (AI) in grading histological disease severity. Level of evidence and recommendation grade were included in accordance with the National Health and Medical Research Council, Australia guidelines of Australia. Results: Consensus was reached on 37 out of 38 statements concerning definitions, pathology processing and reporting, scoring system and relevance to clinical outcomes. Knowledge gaps were identified with uncertainty over the role of AI. Conclusion: These consensus statements provide recommendations, with specific relevance to the Asia Pacific region, on the role of histology in IBD to harmonise its use. The statements will promote understanding and applicability in research and in the routine management of IBD.

KW - consensus

KW - Crohn’s disease

KW - histology

KW - inflammatory bowel disease

KW - ulcerative colitis

UR - https://www.scopus.com/pages/publications/105024544163

U2 - 10.1177/17562848251363703

DO - 10.1177/17562848251363703

M3 - Article

C2 - 40842459

AN - SCOPUS:105024544163

SN - 1756-283X

VL - 18

SP - 1

EP - 20

JO - Therapeutic Advances in Gastroenterology

JF - Therapeutic Advances in Gastroenterology

ER -

Asia Pacific association of gastroenterology consensus statements on histopathological evaluation of inflammatory bowel diseases

Abstract

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Keywords

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