Mitselos Ioannis V, Katsanos Konstantinos H, Tatsioni Athina, Skamnelos Alexandros, Eliakim Rami, Tsianos Epameinondas V, Christodoulou Dimitrios K
Departments of Gastroenterology.
Internal Medicine, School of Health Sciences, Faculty of Medicine, University Hospital of Ioannina, University of Ioannina, Ioannina, Greece.
Eur J Gastroenterol Hepatol. 2018 Aug;30(8):861-867. doi: 10.1097/MEG.0000000000001146.
Mucosal healing is an established treatment endpoint in Crohn's disease (CD). Still, clinical indices and inflammatory markers are used widely in CD surveillance.
The aim of this study was to investigate the diagnostic performance as well as the relationship of C-reactive protein (CRP) and Crohn's Disease Activity Index (CDAI) with small bowel capsule endoscopy's (SBCE) inflammation scoring index, the Lewis Score (LS).
CDAI, CRP, and SBCE findings of 30 CD patients with isolated small bowel disease were retrieved from our academic institution patient records and were analyzed statistically.
SBCE showed significant mucosal inflammation [mean (SD) LS: 1599 (1380)], in nine (60.0%) of 15 patients who were in both clinical and biochemical remission. CDAI and CRP showed a weak and moderate correlation with LS (r=0.317, P=0.088 and r=0.516, P=0.004, respectively). The diagnostic performance of CDAI and CRP in predicting mucosal inflammation was as follows: sensitivity 23.8 and 52.4%; specificity 100 and 66.7%; positive predictive value 100 and 78.6%; and negative predictive value 36.0 and 37.5%. The area under the curve toward endoscopic activity prediction was 0.70 and 0.69, respectively.
Both CDAI and CRP underestimated endoscopic activity as expressed by the LS in a significant proportion of patients with quiescent disease.
黏膜愈合是克罗恩病（CD）既定的治疗终点。然而，临床指标和炎症标志物仍广泛用于CD的监测。
本研究旨在探讨C反应蛋白（CRP）和克罗恩病活动指数（CDAI）与小肠胶囊内镜检查（SBCE）炎症评分指数即刘易斯评分（LS）之间的诊断效能及关系。
从我们学术机构的患者记录中检索30例孤立性小肠疾病CD患者的CDAI、CRP和SBCE检查结果，并进行统计学分析。
在15例临床和生化指标均处于缓解期的患者中，有9例（60.0%）的SBCE显示出明显的黏膜炎症[平均（标准差）LS：1599（1380）]。CDAI和CRP与LS的相关性较弱和中等（r分别为0.317，P = 0.088；r为0.516，P = 0.004）。CDAI和CRP在预测黏膜炎症方面的诊断效能如下：敏感性分别为23.8%和52.4%；特异性分别为100%和66.7%；阳性预测值分别为100%和78.6%；阴性预测值分别为36.0%和37.5%。预测内镜活动度的曲线下面积分别为0.70和0.69。
在相当一部分病情静止的患者中，CDAI和CRP均低估了由LS所表示的内镜活动度。
