Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan.
Center for Advanced IBD Research and Treatment, Kitasato University, Kitasato Institute Hospital, Tokyo, Japan.
Inflamm Bowel Dis. 2018 Nov 29;24(12):2641-2647. doi: 10.1093/ibd/izy193.
The usefulness of second-generation colon capsule endoscopy (CCE-2) for ulcerative colitis (UC) has not been fully demonstrated. This study aimed to develop an endoscopic severity score of UC for CCE-2.
Patients diagnosed with UC were enrolled prospectively and underwent colonoscopy and CCE-2 on the same day. The collected CCE-2 videos were adopted for the development of the score. These videos were scored by 4 blinded inflammatory bowel disease experts. The items validated with the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) were used as the candidate items, some of which were automatically assessed using the workstation. Each item was divided into proximal and distal parts at the splenic flexure and then individually assessed. The image readers simultaneously evaluated the inflammation severity using the visual analog scale (VAS). The descriptors that contribute to this scale were evaluated, and a model to predict the VAS was constructed. The UCEIS was scored by other endoscopists using colonoscopy videos. The correlation coefficients with fecal calprotectin, blood tests, and Lichtiger index were calculated.
The final scoring system was fixed as "vascular pattern sum (proximal + distal) + bleeding sum + erosions and ulcers sum (minimum-maximum, 0-14)" and was named Capsule Scoring of Ulcerative Colitis (CSUC). The correlation coefficient of CSUC with biomarkers and clinical score was similar to that of the UCEIS.
We developed a new simple score using the 3 descriptors of CCE-2.
第二代结肠胶囊内镜（CCE-2）在溃疡性结肠炎（UC）中的应用价值尚未得到充分证实。本研究旨在为 CCE-2 开发一种 UC 的内镜严重程度评分。
前瞻性纳入诊断为 UC 的患者，并在同一天进行结肠镜检查和 CCE-2。收集的 CCE-2 视频用于评分。这些视频由 4 名盲法炎症性肠病专家进行评分。使用溃疡性结肠炎内镜严重程度指数（UCEIS）验证的项目作为候选项目，其中一些使用工作站自动评估。每个项目在脾曲处分为近端和远端部分，然后分别进行评估。图像阅读器同时使用视觉模拟量表（VAS）评估炎症严重程度。评估有助于该量表的描述符，并构建预测 VAS 的模型。其他内镜医生使用结肠镜视频对 UCEIS 进行评分。计算与粪便钙卫蛋白、血液检查和 Lichtiger 指数的相关系数。
最终评分系统固定为“血管模式总和（近端+远端）+出血总和+糜烂和溃疡总和（最小值-最大值，0-14）”，命名为溃疡性结肠炎胶囊评分（CSUC）。CSUC 与生物标志物和临床评分的相关系数与 UCEIS 相似。
我们使用 CCE-2 的 3 个描述符开发了一种新的简单评分。
