Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada; Robarts Clinical Trials, London, Canada.
Department of Gastroenterology and Hepatology, Amsterdam UMC, University Medical Center, Amsterdam, the Netherlands.
Clin Gastroenterol Hepatol. 2020 Aug;18(9):2139-2141.e2. doi: 10.1016/j.cgh.2019.08.046. Epub 2019 Aug 29.
Endoscopic evaluation for postoperative recurrence of Crohn's disease (CD) is routinely integrated into clinical practice. The Rutgeerts score (RS) was developed to grade the severity of endoscopic postoperative CD recurrence and has been integrated into clinical practice guidelines and utilized as an endpoint in interventional trials. However, the operating properties of the RS have not been fully assessed. Furthermore, the RS i2 grade groups purely anastomotic ulcerations with those in the neoterminal ileum, whereas the modified Endoscopic Postoperative Recurrence Score (mEPRS) distinguishes lesions limited to the ileocolic anastomosis (i2a) from those in the neoterminal ileum (i2b). Accurate characterization of endoscopic recurrence is an important determinant for initiating postoperative medical therapy. Therefore, variability in endoscopic scoring may result in inappropriate therapeutic decisions. We evaluated the reliability of endoscopic assessment of postoperative CD recurrence among independent blinded central readers.
内镜评估克罗恩病（CD）术后复发已常规纳入临床实践。 Rutgeerts 评分（RS）用于分级内镜评估术后 CD 复发的严重程度，并已纳入临床实践指南，作为干预试验的终点。然而，RS 的操作特性尚未得到充分评估。此外，RS i2 级分组单纯将吻合口溃疡与末段回肠的溃疡相混淆，而改良内镜术后复发评分（mEPRS）则区分了仅限于回结肠吻合口的病变（i2a）和末段回肠的病变（i2b）。准确描述内镜复发是启动术后药物治疗的重要决定因素。因此，内镜评分的变异性可能导致不适当的治疗决策。我们评估了独立盲法中心阅片者对术后 CD 复发内镜评估的可靠性。
