Kohashi Michitaka, Nishiumi Shin, Ooi Makoto, Yoshie Tomoo, Matsubara Atsuki, Suzuki Makoto, Hoshi Namiko, Kamikozuru Koji, Yokoyama Yoko, Fukunaga Ken, Nakamura Shiro, Azuma Takeshi, Yoshida Masaru
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chu-o-ku, Kobe, Hyogo 650-0017, Japan.
Division of Lower Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan.
J Crohns Colitis. 2014 Sep;8(9):1010-21. doi: 10.1016/j.crohns.2014.01.024. Epub 2014 Feb 26.
BACKGROUND & AIMS: To improve the clinical course of ulcerative colitis (UC), more accurate serum diagnostic and assessment methods are required. We used serum metabolomics to develop diagnostic and assessment methods for UC.
Sera from UC patients, Crohn's disease (CD) patients, and healthy volunteers (HV) were collected at multiple institutions. The UC and HV were randomly allocated to the training or validation set, and their serum metabolites were analyzed by gas chromatography mass spectrometry (GC/MS). Using the training set, diagnostic and assessment models for UC were established by multiple logistic regression analysis. Then, the models were assessed using the validation set. Additionally, to establish a diagnostic model for discriminating UC from CD, the CD patients' data were used.
The diagnostic model for discriminating UC from HV demonstrated an AUC of 0.988, 93.33% sensitivity, and 95.00% specificity in the training set and 95.00% sensitivity and 98.33% specificity in the validation set. Another model for discriminating UC from CD exhibited an AUC of 0.965, 85.00% sensitivity, and 97.44% specificity in the training set and 83.33% sensitivity in the validation set. The model for assessing UC showed an AUC of 0.967, 84.62% sensitivity, and 88.23% specificity in the training set and 84.62% sensitivity, 91.18% specificity, and a significant correlation with the clinical activity index (rs=0.7371, P<0.0001) in the validation set.
Our models demonstrated high performance and might lead to the development of a novel treatment selection method based on UC condition.
为改善溃疡性结肠炎(UC)的临床病程,需要更准确的血清诊断和评估方法。我们采用血清代谢组学来开发UC的诊断和评估方法。
在多个机构收集UC患者、克罗恩病(CD)患者和健康志愿者(HV)的血清。将UC患者和HV随机分配到训练集或验证集,采用气相色谱 - 质谱联用(GC/MS)分析其血清代谢物。利用训练集,通过多元逻辑回归分析建立UC的诊断和评估模型。然后,使用验证集对模型进行评估。此外,为建立区分UC与CD的诊断模型,使用了CD患者的数据。
在训练集中,区分UC与HV的诊断模型的曲线下面积(AUC)为0.988,灵敏度为93.33%,特异度为95.00%;在验证集中,灵敏度为95.00%,特异度为98.33%。另一个区分UC与CD的模型在训练集中的AUC为0.965,灵敏度为85.00%,特异度为97.44%;在验证集中,灵敏度为83.33%。评估UC的模型在训练集中的AUC为0.967,灵敏度为84.62%,特异度为88.23%;在验证集中,灵敏度为84.62%,特异度为91.18%,且与临床活动指数有显著相关性(rs = 0.7371,P < 0.0001)。
我们的模型表现出高性能,可能会促成基于UC病情的新型治疗选择方法的开发。