*Department of Medicine, Section of Gastroenterology, Boston University School of Medicine, Boston, Massachusetts; †Department of Medicine, Boston University School of Medicine, Boston, Massachusetts; ‡Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts; §Department of Biomedical Engineering, College of Engineering, Boston University, Boston, Massachusetts; and ‖Gastroenterology Unit, Medical Service, VA Boston Healthcare System, Boston, Massachusetts.
Inflamm Bowel Dis. 2014 Jun;20(6):1029-36. doi: 10.1097/MIB.0000000000000058.
In 10% to 15% of individuals, inflammatory bowel disease (IBD) is difficult to classify as ulcerative colitis (UC) or Crohn's disease (CD). Previous work has demonstrated that probe-based elastic scattering spectroscopy (ESS) can produce spectra, informed by parameters like tissue ultrastructure and hemoglobin content, capable of differentiating pathologies. This study investigates whether ESS is an in vivo optical biomarker for the presence, activity, and type of IBD in the colon.
Pilot study, a retrospective data analysis. ESS spectra of endoscopically normal and inflamed colon were obtained from 48 patients with IBD and 46 non-IBD controls. Measurements from patients with IBD were categorized as CD or UC based on clinical diagnosis. Spectra were analyzed using high-dimensional methods. Leave-one-patient-out cross-validation was used to obtain diagnostic performance estimates.
Patients with IBD were distinguishable from non-IBD controls with a sensitivity of 0.93 and specificity of 0.91 based on readings from endoscopically normal mucosa, and 0.94 and 0.93 from inflamed mucosa. In patients with IBD, histologically normal and inflamed colon were distinguishable with per-class accuracies of 0.83 and 0.89, respectively; histologically normal from inactive inflammation with accuracies of 0.73 and 0.89, respectively; and inactive from active colitis with accuracies of 0.87 and 0.84, respectively. The diagnosis of CD versus UC was made with per-class accuracies of 0.92 and 0.87 in normal and 0.87 and 0.85 in inflamed mucosa, respectively.
ESS, a simple, low-cost clinically friendly optical biopsy modality, has the potential to enhance the endoscopic assessment of IBD and its activity in real time and may help to distinguish CD from UC.
在 10%至 15%的个体中，炎症性肠病（IBD）难以分类为溃疡性结肠炎（UC）或克罗恩病（CD）。先前的工作表明，基于探针的弹性散射光谱（ESS）可以产生光谱，这些光谱由组织超微结构和血红蛋白含量等参数提供信息，能够区分病理学。本研究调查 ESS 是否是一种用于在体内识别结肠中 IBD 的存在、活性和类型的光学生物标志物。
这是一项前瞻性研究，回顾性数据分析。从 48 名 IBD 患者和 46 名非 IBD 对照组中获得内镜正常和炎症结肠的 ESS 光谱。根据临床诊断，将 IBD 患者的测量结果分为 CD 或 UC。使用高维方法分析光谱。采用留一患者外交叉验证法获得诊断性能估计。
根据内镜正常黏膜的读数，IBD 患者与非 IBD 对照组之间的区分具有 0.93 的敏感性和 0.91 的特异性，而炎症黏膜的区分具有 0.94 和 0.93 的敏感性和特异性。在 IBD 患者中，组织学正常和炎症结肠的分类准确率分别为 0.83 和 0.89；组织学正常与无活性炎症的准确率分别为 0.73 和 0.89；无活性与活动性结肠炎的准确率分别为 0.87 和 0.84。正常和炎症黏膜的 CD 与 UC 的诊断准确率分别为 0.92 和 0.87，以及 0.87 和 0.85。
ESS 是一种简单、低成本、临床友好的光学活检方式，具有实时增强 IBD 及其活性的内镜评估的潜力，并且可能有助于区分 CD 与 UC。
