Nancy Histological Index (Ulcerative Colitis)
The Nancy histological index for ulcerative colitis (Marchal-Bressenot and colleagues, Gut 2017), grading histologic activity 0 to 4.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Ulcers or erosions
- No
- Neutrophilic infiltrate
- Moderate or severe increase: multiple clusters of neutrophils in the…
Result: Nancy histological index 3
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Grade 4
- Ulcers or erosions. Decided outright; the other features are not consulted.
- Grade 3
- Multiple easily apparent clusters of neutrophils.
- Grade 2
- Few or rare neutrophils, difficult to see.
- Grade 1
- Moderate or severe chronic infiltrate. A DEAD END: chronic change can never exceed 1.
- Grade 0
- No or only mild increase in chronic inflammatory cells.
- Thresholds
- Remission = 0; response 1 or less. The stated no-neutrophil condition is structurally guaranteed.
- Scope
- Histologic activity only. Does not diagnose UC, assess dysplasia, or select therapy.
What you enter
- Ulcers or erosions.
- Neutrophilic infiltrate.
- Chronic inflammatory infiltrate.
Full field descriptions
- Ulcers or erosions. CHECKED FIRST: their presence gives grade 4 outright, and the other two features are not consulted.
- Neutrophilic infiltrate. Checked SECOND, only when there is no ulceration [none = No neutrophils (fall through to the chronic infiltrate); mild = Mild increase: few or rare neutrophils in the lamina propria or epithelium, difficult to see, grade 2; moderate-severe = Moderate or severe increase: multiple clusters of neutrophils in the lamina propria and/or epithelium, easily apparent, grade 3]
- Chronic inflammatory infiltrate. Consulted LAST, only when neutrophils are absent, and A DEAD END AT GRADE 1 [none-or-mild = No or only mild increase in chronic inflammatory cells, grade 0; moderate-severe = Moderate or severe increase in chronic inflammatory cells (lymphocytes, plasma cells and eosinophils), easily apparent, grade 1]
How this is calculated
- Structure
- A DECISION TREE, not a sum. Ulceration, then neutrophils, then chronic infiltrate. First to fire wins.
- Denominator
- The SET of biopsies from the visit: the worst biopsy wins. Averaging ratings will not reproduce it.
Marchal-Bressenot A, Salleron J, Boulagnon-Rombi C, et al. Development and validation of the Nancy histological index for UC. Gut. 2017;66(1):43-49. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.