克罗恩病内镜与组织学验证评分指标之间的相关性

Correlation between endoscopic and histological validated scoring indices in Crohn's disease.

作者信息

Gong Wenbin, Guo Kun, Zheng Tao, Fang Miao, Xie Haohao, Li Weijie, Hong Zhiwu, Ren Huajian, Gu Guosheng, Wang Gefei, Wu Xiuwen, Wang Zhiming, Ren Jianan, Li Jieshou

机构信息

School of Medicine, Southeast University, Department of General Surgery, Jinling Hospital, PR China.

Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, PR China.

出版信息

Dig Liver Dis. 2019 Jun;51(6):812-817. doi: 10.1016/j.dld.2019.01.010. Epub 2019 Jan 22.

DOI:10.1016/j.dld.2019.01.010

PMID:30718202

Abstract

BACKGROUND

It is of crucial importance to evaluate disease activity by means of endoscopy and histopathology in Crohn's disease (CD). Nonetheless, correlation between endoscopic and histological validated indices has not been verified.

AIMS

We aim to correlate the Simple Endoscopic Score for Crohns disease (SES-CD) with two validated widely used histological indices in patients with established CD.

METHODS

The SES-CD at the worst affected area was scored and histological disease activity using Global Histologic Disease Activity Score (GHAS or D'Haens score) and the Naini and Cortina Score (NCS) was scored independently by two pathologists blinded to the clinical information and endoscopic results. Spearman correlation between the SES-CD, GHAS and NCS were performed.

RESULTS

143 patients, 32 with SES-CD scores 0-2, 57 with 3-6, 37 with 7-15, and 17 with ≥16. Correlation coefficients between SES-CD and GHAS were r = 0.86 (95% CI 0.80-0.91, p < 0.001) and between SES-CD and NCS r = 0.85 (95% CI 0.81-0.88, p < 0.001). There was a strong correlation between the two histological indices (r = 0.70, 95% CI 0.59-0.78, p < 0.001). Mucosal healing without histological disease activity was most correlated with SES-CD score 0 or 1.

CONCLUSIONS

The SES-CD strongly correlates with both GHAS and NCS. The SES-CD of 0 to 1 best represents histological remission that correlates with quiescent disease activity.

摘要

背景

通过内镜检查和组织病理学评估克罗恩病（CD）的疾病活动至关重要。然而，内镜和组织学验证指标之间的相关性尚未得到证实。

目的

我们旨在将克罗恩病简易内镜评分（SES-CD）与两种广泛使用的已验证组织学指标在确诊CD患者中进行关联。

方法

对最严重受累区域的SES-CD进行评分，并由两名对临床信息和内镜检查结果不知情的病理学家独立对使用全球组织学疾病活动评分（GHAS或D'Haens评分）和奈尼与科尔蒂纳评分（NCS）的组织学疾病活动进行评分。对SES-CD、GHAS和NCS进行Spearman相关性分析。

结果

143例患者，32例SES-CD评分为0 - 2，57例为3 - 6，37例为7 - 15，17例≥16。SES-CD与GHAS之间的相关系数为r = 0.86（95%CI 0.80 - 0.91，p < 0.001），SES-CD与NCS之间的相关系数为r = 0.85（95%CI 0.81 - 0.88，p < 0.001）。两种组织学指标之间存在强相关性（r = 0.70，95%CI 0.59 - 0.78，p < 0.001）。无组织学疾病活动的黏膜愈合与SES-CD评分为0或1的相关性最强。