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溃疡性结肠炎的临床、内镜和组织学相关性及关联度量。

Clinical, endoscopic and histological correlation and measures of association in ulcerative colitis.

机构信息

Department of Gastroenterology, Clínica Las Condes, Santiago, Chile.

Academic Department Research Unit, Clínica Las Condes, Santiago, Chile.

出版信息

J Dig Dis. 2017 Nov;18(11):634-641. doi: 10.1111/1751-2980.12546.

Abstract

OBJECTIVE

To determine the correlation between clinical, fecal, endoscopic and histological activity in patients with ulcerative colitis (UC).

METHODS

A correlational cross-sectional analysis was performed in patients with UC who underwent colonoscopy between February and December 2016. Clinical, endoscopic, fecal and histological activities were determined using the partial Mayo subscore, Mayo endoscopic subscore and modified Mayo endoscopic subscore, fecal calprotectin and Geboes score and the presence of basal plasmacytosis, respectively. Scores were analyzed using Spearman's rank correlation test. To determine the association between scores and some clinical variables and active UC, univariate and multivariate logistic regressions were used.

RESULTS

Altogether 105 procedures (93 patients) were included. In 64.8% of the procedures, the mucosa was inflamed; however, 14.7% did not show histological inflammation. Endoscopic remission was observed in the other 35.2% of procedures; however, in biopsies 21.6% exhibited histological inflammation. Mayo endoscopic subscore and modified Mayo endoscopic score were well correlated but were only moderately correlated with clinical and histological scores. Furthermore, there was a moderate correlation between Mayo endoscopic score and Geboes score. Conversely, histological scores were poorly correlated with partial Mayo score. In multivariate analysis, Geboes score and basal plasmacytosis were predictive of active disease (OR 3.505, 95% CI 1.544-7.959 and OR 3.240, 95% CI 1.123-9.349, respectively), whereas biological therapy was found to be protective against UC (OR 0.021, 95% CI 0.000-0.641).

CONCLUSION

Clinical, endoscopic and histological activities were moderately correlated, while Geboes score and basal plasmacytosis were predictive of endoscopically active UC.

摘要

目的

确定溃疡性结肠炎(UC)患者的临床、粪便、内镜和组织学活动之间的相关性。

方法

对 2016 年 2 月至 12 月间接受结肠镜检查的 UC 患者进行了相关性横断面分析。使用部分 Mayo 亚评分、Mayo 内镜亚评分和改良 Mayo 内镜亚评分、粪便钙卫蛋白和 Geboes 评分以及基底浆细胞存在情况分别确定临床、内镜、粪便和组织学活动。使用 Spearman 秩相关检验分析评分。使用单变量和多变量逻辑回归确定评分与某些临床变量和活动性 UC 之间的关系。

结果

共纳入 105 例(93 例患者)操作。在 64.8%的操作中,黏膜有炎症;然而,14.7%的操作没有显示组织学炎症。在另外 35.2%的操作中观察到内镜缓解;然而,在活检中 21.6%显示出组织学炎症。Mayo 内镜亚评分和改良 Mayo 内镜评分相关性良好,但仅与临床和组织学评分中度相关。此外,Mayo 内镜评分与 Geboes 评分中度相关。相反,组织学评分与部分 Mayo 评分相关性较差。在多变量分析中,Geboes 评分和基底浆细胞是活动性疾病的预测因素(OR 3.505,95%CI 1.544-7.959 和 OR 3.240,95%CI 1.123-9.349),而生物治疗被发现可预防 UC(OR 0.021,95%CI 0.000-0.641)。

结论

临床、内镜和组织学活动中度相关,而 Geboes 评分和基底浆细胞是预测内镜活动 UC 的指标。

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