The University of Melbourne, Parkville, VIC, Australia.
Department of Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Parkville, VIC, Australia.
Inflamm Bowel Dis. 2021 Nov 15;27(Supplement_2):S25-S32. doi: 10.1093/ibd/izab180.
Patients with Crohn's disease (CD) undergo frequent endoscopic procedures, with visualization of the gastrointestinal mucosa central to treatment decision-making. Subsequently, a noninvasive alternative to optical colonoscopy (OC) would be welcomed. One such technology is capsule endoscopy, including the PillCam COLON 2 (PCC2), though research validating its use in ileocolonic CD is limited. This study aims to compare PCC2 with ileocolonoscopy (OC) in assessing mucosal CD through use of a standardized scoring system.
At an Australian tertiary hospital, same-day PCC2 and ileocolonoscopy results of 47 CD patients, with known nonstricturing disease, were prospectively collected and analyzed for correlation and agreement. Deidentified recordings were reported by a single expert gastroenterologist. Mucosal disease was quantified using the Simple Endoscopic Score for Crohn's Disease (SES-CD). The SES-CD results of paired endoscopic modalities were compared in total per bowel segment and per SES-CD variable.
Of 47 PCC2 recordings, 68% were complete, fully assessing terminal ileum to rectum, and OC was complete in 89%. Correlation (r) between total SES-CD scores was strongest in the terminal ileum (r = 0.77, P < .001), with the SES-CD variable of "ulcer detection" showing the strongest agreement. The PCC2 (vs OC) identified additional ulcers in the terminal ileum; ascending, transverse, and descending colon; and rectum; scores were 5 (1), 5 (3), 1 (1), 2 (1), and 2 (2), respectively.
The PCC2 shows promise in assessing ileocolonic mucosa, especially in proximal bowel segments, with greater reach of visualization in the small bowel. Given the resource and safety considerations raised by the Coronavirus disease 2019 pandemic, capsule endoscopy has particular significance.This article aims to contribute to the limited body of research surrounding the validity of capsule endoscopy technology in assessing ileocolonic mucosa in Crohn's Disease patients. In doing so, an alternative option for patients enduring frequent endoscopies is given potential.
克罗恩病（CD）患者经常需要进行内镜检查，而胃肠道黏膜的可视化是治疗决策的关键。因此，人们期待有一种非侵入性的替代光学结肠镜检查（OC）的方法。胶囊内镜就是这样一种技术，其中包括 PillCam COLON 2（PCC2），尽管验证其在回结肠 CD 中应用的研究有限。本研究旨在通过使用标准化评分系统比较 PCC2 与回结肠镜检查（OC）在评估黏膜 CD 方面的效果。
在澳大利亚的一家三级医院，前瞻性地收集并分析了 47 例已知无狭窄病变的 CD 患者同日进行的 PCC2 和回结肠镜检查结果，以进行相关性和一致性分析。由一位经验丰富的胃肠病专家对无法识别身份的记录进行报告。采用简单克罗恩病内镜评分（SES-CD）量化黏膜疾病。比较了配对内镜方式的总 SES-CD 评分和每个 SES-CD 变量的评分。
47 份 PCC2 记录中有 68%是完整的，可全面评估末端回肠至直肠，而 OC 则有 89%是完整的。总 SES-CD 评分之间的相关性（r）在末端回肠最强（r=0.77，P<0.001），“溃疡检出”这一 SES-CD 变量的一致性最强。PCC2（与 OC 相比）在末端回肠、升结肠、横结肠、降结肠和直肠中发现了更多的溃疡；评分分别为 5（1）、5（3）、1（1）、2（1）和 2（2）。
PCC2 在评估回结肠黏膜方面具有一定的前景，特别是在近端肠段，其在小肠中的可视范围更大。鉴于 2019 年冠状病毒病（COVID-19）大流行带来的资源和安全考虑，胶囊内镜具有特殊的意义。本文旨在为胶囊内镜技术在评估克罗恩病患者回结肠黏膜方面的有效性方面有限的研究提供补充，为频繁接受内镜检查的患者提供了一种潜在的替代方案。
