Liu Ruiqing, Liu Shunli, Yi Li, Wang Dongsheng, Zhou Xiaoming, Zhiming Wang, Ren Keyu, Ke Jia, Zhu Weiming, Lu Yun
Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, China.
Department of Radiology, The Affiliated Hospital of Qingdao University Qingdao, 16 Jiangsu Road, Qingdao, Shandong, China.
Heliyon. 2023 Sep 7;9(9):e19942. doi: 10.1016/j.heliyon.2023.e19942. eCollection 2023 Sep.
To develop novel multiparametric models based on computed tomography enterography (CTE) scores to identify endoscopic activity and surgical risk in patients with Crohn's disease (CD).
We analyzed 171 patients from 3 hospitals. Correlations between CTE outcomes and endoscopic scores were assessed using Spearman's rank correlation analysis. Predictive models for moderate to severe CD were developed, and receiver operating characteristic (ROC) curves were constructed to determine the area under the ROC curve (AUC). A combined nomogram based on CTE scores and clinical variables was also developed for predicting moderate to severe CD and surgery.
CTE scores were significantly correlated with endoscopy scores at the segment level. The global CTE score was an independent predictor of severe (HR = 1.231, 95% CI: 1.048-1.446, p = 0.012) and moderate-to-severe Simplified Endoscopic Scores for Crohn's Disease (SES-CD) (HR = 1.202, 95% CI: 1.090-1.325, p < 0.001). The nomogram integrating CTE and clinical data predicted moderate to severe SES-CD and severe SES-CD scores in the validation cohort with AUCs of 0.837 and 0.807, respectively. The CTE score (HR = 1.18; 95% CI: 1.103-1.262; p = 0.001) and SES-CD score (HR = 3.125, 95% CI: 1.542-6.33; p = 0.001) were independent prognostic factors for surgery-free survival. A prognostic nomogram incorporating CTE scores, SES-CD and C-reactive protein (CRP) accurately predicted the risk of surgery in patients with CD.
The newly developed CTE score and multiparametric models displayed high accuracy in predicting moderate to severe CD and surgical risk for CD patients.
基于计算机断层扫描小肠造影（CTE）评分开发新的多参数模型，以识别克罗恩病（CD）患者的内镜活动度和手术风险。
我们分析了来自3家医院的171例患者。使用Spearman等级相关分析评估CTE结果与内镜评分之间的相关性。开发了中重度CD的预测模型，并构建受试者工作特征（ROC）曲线以确定ROC曲线下面积（AUC）。还开发了基于CTE评分和临床变量的联合列线图，用于预测中重度CD和手术情况。
CTE评分与节段水平的内镜评分显著相关。总体CTE评分是重度克罗恩病（HR = 1.231，95%CI：1.048 - 1.446，p = 0.012）和中重度克罗恩病简化内镜评分（SES - CD）（HR = 1.202，95%CI：1.090 - 1.325，p < 0.001）的独立预测因素。整合CTE和临床数据的列线图在验证队列中预测中重度SES - CD和重度SES - CD评分的AUC分别为0.837和0.807。CTE评分（HR = 1.18；95%CI：1.103 - 1.262；p = 0.001）和SES - CD评分（HR = 3.125，95%CI：1.542 - 6.33；p = 0.001）是无手术生存的独立预后因素。纳入CTE评分、SES - CD和C反应蛋白（CRP）的预后列线图能准确预测CD患者的手术风险。
新开发的CTE评分和多参数模型在预测CD患者的中重度病情和手术风险方面显示出高度准确性。
