Park Kwangbeom, Ahn Bokyung, Jung Kee Wook, Park Young Soo, Lee Jun Su, Kim Ga Hee, Na Hee Kyong, Ahn Ji Yong, Lee Jeong Hoon, Kim Do Hoon, Choi Kee Don, Song Ho June, Lee Gin Hyug, Jung Hwoon-Yong
Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Neurogastroenterol Motil. 2024 Oct 30;30(4):430-436. doi: 10.5056/jnm23172.
BACKGROUND/AIMS: The proposed eosinophilic esophagitis (EoE) endoscopic reference score serves to diagnose and evaluate treatment responses in EoE. Nevertheless, the validated reference score thresholds for diagnosis and treatment response in Asian patients are yet to be established. This study aims to establish these thresholds for the first time among Asian patients with EoE.
Patients presenting with ≥ 15 eosinophils/high power field and esophageal dysfunction symptoms between August 2007 and November 2021 were included. Age- and sex-matched non-EoE controls were also enrolled. Baseline characteristics, endoscopic reference score features, and scores were compared between patients and controls. Among patients, endoscopic reference score features and scores, along with peak eosinophil counts, were evaluated both before and after treatment. The optimal threshold was determined based on sensitivity, specificity, and the Youden index.
Overall, 102 patients were enrolled (74.5% men; mean age, 46.9 years). The mean endoscopic reference score was 2.65 and 0.52 for patients and controls, respectively ( < 0.001). An endoscopic reference score ≥ 2 was identified as the optimal diagnostic threshold for EoE (sensitivity, 0.79; specificity, 0.86; Youden index, 0.66). Post-treatment data regarding endoscopic findings and histology were available for 30 patients. Regarding histologic response, an endoscopic reference score of ≤ 3 demonstrated the optimal threshold (sensitivity, 0.95; specificity, 0.88; Youden index, 0.83).
The optimal diagnostic and treatment response thresholds were determined to be endoscopic reference scores of ≥ 2 and ≤ 3, respectively. Further studies involving a larger patient cohort are necessary to validate these findings.
背景/目的：拟议的嗜酸性粒细胞性食管炎（EoE）内镜参考评分用于诊断和评估EoE的治疗反应。然而，亚洲患者中用于诊断和治疗反应的经过验证的参考评分阈值尚未确定。本研究旨在首次在亚洲EoE患者中确定这些阈值。
纳入2007年8月至2021年11月间每高倍视野嗜酸性粒细胞≥15个且有食管功能障碍症状的患者。还纳入了年龄和性别匹配的非EoE对照。比较患者和对照的基线特征、内镜参考评分特征及评分。在患者中，治疗前后均评估内镜参考评分特征及评分，以及嗜酸性粒细胞峰值计数。根据敏感性、特异性和尤登指数确定最佳阈值。
共纳入102例患者（男性占74.5%；平均年龄46.9岁）。患者和对照的平均内镜参考评分分别为2.65和0.52（<0.001）。内镜参考评分≥2被确定为EoE的最佳诊断阈值（敏感性0.79；特异性0.86；尤登指数0.66）。30例患者有治疗后内镜检查结果和组织学方面的数据。关于组织学反应，内镜参考评分≤3显示为最佳阈值（敏感性0.95；特异性0.88；尤登指数0.83）。
最佳诊断和治疗反应阈值分别确定为内镜参考评分≥2和≤3。需要进一步纳入更大患者队列的研究来验证这些结果。
