Buscaglia Jonathan M, Giday Samuel A, Kantsevoy Sergey V, Clarke John O, Magno Priscilla, Yong Elaine, Mullin Gerard E
Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Clin Gastroenterol Hepatol. 2008 Mar;6(3):298-301. doi: 10.1016/j.cgh.2007.12.029. Epub 2008 Feb 6.
BACKGROUND & AIMS: The suspected blood indicator (SBI) feature of wireless capsule endoscopy (WCE) was developed for rapid screening of intestinal lesions with bleeding potential. Our aim was to assess the accuracy and performance characteristics of the SBI according to the indications for study in a large cohort of patients.
We reviewed collected data on all WCE studies performed at Johns Hopkins Hospital from January 2006 to June 2007. Study indications were as follows: anemia of unknown origin (n = 53), obscure gastrointestinal bleeding (n = 112), suspected Crohn's disease (n = 122), and other (n = 4). Concordant and discordant findings between gastroenterologists' readings and SBI were recorded for each patient.
A total of 221 lesions with bleeding potential was detected. The overall sensitivity, specificity, positive predictive value, and negative predictive value for the SBI were 56.4%, 33.5%, 24.0%, and 67.3%, respectively. For actively bleeding lesions, the SBI sensitivity and positive predictive value were only 58.3% and 70%, respectively. The sensitivity was highest (64%) in patients undergoing WCE for suspected Crohn's disease, with a negative predictive value of 80.4%. The sensitivity was only 58.3% and 41.3%, respectively, in studies performed for obscure gastrointestinal bleeding and anemia.
Performance characteristics of the currently available SBI feature in WCE are suboptimal and insufficient to screen for lesions with bleeding potential. Even in patients with active intestinal bleeding, the sensitivity of SBI was less than 60%, which is lower than previously reported. However, in patients with suspected Crohn's disease, the high sensitivity and negative predictive value of SBI may make it a useful tool for the detection of large areas of abnormal mucosa.
无线胶囊内镜（WCE）的可疑血液指标（SBI）功能是为快速筛查具有出血潜在风险的肠道病变而开发的。我们的目的是在一大群患者中，根据研究适应症评估SBI的准确性和性能特征。
我们回顾了2006年1月至2007年6月在约翰霍普金斯医院进行的所有WCE研究收集的数据。研究适应症如下：不明原因贫血（n = 53）、不明原因胃肠道出血（n = 112）、疑似克罗恩病（n = 122）以及其他（n = 4）。记录每位患者胃肠病学家的解读与SBI之间的一致和不一致结果。
共检测到221个具有出血潜在风险的病变。SBI的总体敏感性、特异性、阳性预测值和阴性预测值分别为56.4%、33.5%、24.0%和67.3%。对于活动性出血病变，SBI的敏感性和阳性预测值分别仅为58.3%和70%。在因疑似克罗恩病接受WCE检查的患者中，敏感性最高（64%），阴性预测值为80.4%。在针对不明原因胃肠道出血和贫血进行的研究中，敏感性分别仅为58.3%和41.3%。
WCE中目前可用的SBI功能的性能特征不理想，不足以筛查具有出血潜在风险的病变。即使在肠道活动性出血的患者中，SBI的敏感性也低于60%，低于先前报道。然而，在疑似克罗恩病的患者中，SBI的高敏感性和阴性预测值可能使其成为检测大面积异常黏膜的有用工具。
