Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
Department of Gastroenterology and Hepatology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
J Gastroenterol Hepatol. 2021 Apr;36(4):943-950. doi: 10.1111/jgh.15220. Epub 2020 Sep 3.
The usefulness of second-generation colon capsule endoscopy (CCE2) in ulcerative colitis (UC), especially in clinically inactive patients, has been reported. Capsule Scoring of Ulcerative Colitis (CSUC) was developed as a severity index for UC. We aimed to determine whether CSUC is useful for predicting relapse during clinical remission.
Forty-one UC patients in clinical remission who underwent CCE2 were prospectively registered from April 2016 to August 2019. Patients' CSUC score was obtained; those with subsequent relapse were followed up retrospectively. The correlation of CSUC with white blood cell count, platelet count, albumin, C-reactive protein, fecal calprotectin and fecal lactoferrin levels, and fecal immunochemical test results was evaluated; their predictive values for future relapse were compared.
The correlations of CSUC with white blood cell, platelet, albumin, C-reactive protein, fecal calprotectin, fecal immunochemical test, and fecal lactoferrin values were r = 0.13, 0.27, -0.25, 0.15, 0.50, 0.43, and 0.50, respectively. CSUC was higher in 12 patients who relapsed within 1 year than in 29 patients who remained in clinical remission (2.83 ± 1.95 vs 0.72 ± 1.00, P < 0.01). Receiver operator characteristic curve analysis showed that CSUC ≥ 1 was a predictor of relapse (area under the curve of 0.82, sensitivity of 83.3%, specificity of 58.6%) and maybe superior to fecal biomarkers. In the univariate analysis, patients with CSUC of 0 had a lower relapse rate than those with CSUC of ≧ 1 (P = 0.03, log-rank test). After analyzing patients who underwent CCE2 within 6 months after the successful induction treatment, results showed that those with CSUC of ≤ 1 remained in clinical remission for a year.
CSUC predicts relapse within 1 year in UC patients in clinical remission, especially when used 6 months after induction treatment.
已经报道了第二代结肠胶囊内镜（CCE2）在溃疡性结肠炎（UC）中的应用价值，尤其是在临床无活动的患者中。溃疡性结肠炎胶囊评分（CSUC）是作为 UC 的严重程度指数而开发的。我们旨在确定 CSUC 是否有助于预测临床缓解期的复发。
前瞻性登记了 2016 年 4 月至 2019 年 8 月期间接受 CCE2 的 41 例临床缓解的 UC 患者。获得患者的 CSUC 评分；对随后复发的患者进行回顾性随访。评估 CSUC 与白细胞计数、血小板计数、白蛋白、C 反应蛋白、粪便钙卫蛋白和乳铁蛋白水平以及粪便免疫化学检测结果的相关性；并比较它们对未来复发的预测价值。
CSUC 与白细胞、血小板、白蛋白、C 反应蛋白、粪便钙卫蛋白、粪便免疫化学检测和粪便乳铁蛋白值的相关性分别为 r = 0.13、0.27、-0.25、0.15、0.50、0.43 和 0.50。12 例在 1 年内复发的患者的 CSUC 高于 29 例临床缓解持续的患者（2.83 ± 1.95 比 0.72 ± 1.00，P < 0.01）。受试者工作特征曲线分析显示，CSUC ≥ 1 是复发的预测指标（曲线下面积为 0.82，灵敏度为 83.3%，特异性为 58.6%），且可能优于粪便生物标志物。在单因素分析中，CSUC 为 0 的患者的复发率低于 CSUC ≥ 1 的患者（P = 0.03，对数秩检验）。在分析了在诱导治疗成功后 6 个月内接受 CCE2 的患者后，结果显示 CSUC 为 ≤ 1 的患者在临床缓解期持续 1 年。
CSUC 可预测临床缓解期 UC 患者 1 年内的复发，尤其是在诱导治疗后 6 个月使用时。
