新型图像增强内镜在预测溃疡性结肠炎临床缓解维持中的应用价值

Usefulness of Novel Image-Enhanced Endoscopy for Predicting Maintenance of Clinical Remission in Ulcerative Colitis.

作者信息

Mamiya Yukiyo, Taida Takashi, Kato Jun, Matsusaka Keisuke, Matsubara Yoshiki, Ozaki Tomomi, Ohashi Takuya, Ito Toshiyuki, Mukai Syohei, Syu Nobuaki, Koshibu Yushi, Ozeki Yusuke, Furuya Makoto, Oyama Yuhei, Nakazawa Hayato, Horio Ryosuke, Goto Chihiro, Takahashi Satsuki, Ozawa Yoshihito, Shiko Yuki, Kurosugi Akane, Sonoda Michiko, Kaneko Tatsuya, Ishikawa Tsubasa, Ohta Yuki, Okimoto Kenichiro, Saito Keiko, Matsumura Tomoaki, Ikeda Jun-Ichiro, Kato Naoya

机构信息

Department of Gastroenterology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba, 260-8670, Japan.

Endoscopy Center, Chiba University Hospital, Chiba, Japan.

出版信息

Dig Dis Sci. 2025 Mar;70(3):1167-1177. doi: 10.1007/s10620-025-08849-8. Epub 2025 Jan 27.

DOI:10.1007/s10620-025-08849-8

PMID:39870961

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11920347/

Abstract

PURPOSE

The performance of endoscopic evaluation of ulcerative colitis (UC) using conventional scoring, including Mayo endoscopic subscore (MES) and ulcerative colitis endoscopic index of severity (UCEIS), is not satisfactory. Recently, the usefulness of novel image-enhanced endoscopy (IEE) such as texture and color enhancement imaging (TXI) and red dichromatic imaging (RDI) has been reported in the endoscopic evaluation of UC. We evaluated the performance of IEEs in UC, particularly focusing on the correlation with MES and UCEIS, and prediction of relapse.

METHODS

This is a prospective, observational study. UC patients in clinical remission who underwent colonoscopy with evaluation of IEEs and follow-up for > 3 months were analyzed. TXI and RDI were evaluated using the previously reported scoring system (TXI 0-2 and RDI 1-4). The IEE scores were compared with the conventional scoring, fecal calprotectin levels, and histological findings using Geboes score, and patient's clinical relapse rate stratified by each IEE score was examined.

RESULTS

Both TXI and RDI scores were well-correlated with MES and UCEIS (both p < 0.001), fecal calprotectin levels (p = 0.015 and p = 0.006), and histology evaluated with Geboes score. In the Geboes subscore, the subscore 2B (neutrophil infiltration in lamina propria) was the most correlated with each endoscopic scoring. RDI 3-4 was significantly correlated with subsequent relapse (hazard ratio 3.56, 95% confidence interval 1.13-11.24), but TXI scoring did not predict relapse significantly.

CONCLUSION

The assessment using RDI could be a convenient and useful endoscopic evaluation method for predicting the prognosis of UC.

摘要

目的

使用传统评分方法（包括梅奥内镜亚评分（MES）和溃疡性结肠炎内镜严重程度指数（UCEIS））对溃疡性结肠炎（UC）进行内镜评估的效果并不理想。最近，有报道称新型图像增强内镜检查（IEE），如纹理和颜色增强成像（TXI）以及红色双色成像（RDI），在UC的内镜评估中具有实用性。我们评估了IEE在UC中的性能，特别关注其与MES和UCEIS的相关性以及复发预测。

方法

这是一项前瞻性观察性研究。对临床缓解期且接受结肠镜检查并评估IEE且随访超过3个月的UC患者进行分析。使用先前报道的评分系统（TXI 0 - 2和RDI 1 - 4）对TXI和RDI进行评估。将IEE评分与传统评分、粪便钙卫蛋白水平以及使用格博斯评分的组织学结果进行比较，并检查按每个IEE评分分层的患者临床复发率。

结果

TXI和RDI评分均与MES和UCEIS（均p < 0.001）、粪便钙卫蛋白水平（p = 0.015和p = 0.006）以及用格博斯评分评估的组织学结果高度相关。在格博斯亚评分中，亚评分2B（固有层中性粒细胞浸润）与每种内镜评分的相关性最强。RDI 3 - 4与随后的复发显著相关（风险比3.56，95%置信区间1.13 - 11.24），但TXI评分未显著预测复发。