Sagami Shintaro, Odajima Kazuhiro, Asonoma Kunio, Miyatani Yusuke, Nakano Masaru, Maeda Ichiro, Hibi Toshifumi, Kobayashi Taku
Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
Department of Clinical Laboratory, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
J Crohns Colitis. 2025 Sep 7;19(8). doi: 10.1093/ecco-jcc/jjaf141.
Intestinal ultrasound (IUS) is a valuable tool for assessing short-term responses to treatment of ulcerative colitis (UC). Nevertheless, no prior reports on IUS use, earlier than weeks 6-14, are known for predicting long-term endoscopic responses. This study evaluated whether IUS (transabdominal and transperineal) at week 1 can predict long-term clinical-endoscopic remission (CER) and histo-endoscopic mucosal improvement (HEMI) following advanced therapies.
This was a post-hoc analysis of a prospective study examining the predictive value of IUS at baseline and weeks 1 and 8 after the initiation of advanced therapy in patients with active UC. CER and HEMI were defined based on the Mayo endoscopic subscore and Geboes score assessed from colonoscopy after >14 weeks. The predictive values of the IUS for CER and HEMI were assessed using a receiver operating characteristic analysis.
Of the 69 patients, 15 (21%) achieved CER and 11 (16%) achieved HEMI. At week 1, reduction in rectal bowel wall thickness (Δrectal BWT) was significantly greater in the CER and HEMI groups than those without these improvements (CER: 1.1 ± 0.7 vs -0.1 ± 1.4, P < .01; HEMI: 1.2 ± 0.7 vs 0.0 ± 1.4, P < .01). However, Δrectal BWT at week 8 did not differ between the groups. ΔRectal BWT at week 1 accurately predicted both CER [area under the curve (AUC) 0.75; 95% CI 0.60-0.86; P = .02] and HEMI (AUC 0.79; 95% CI 0.65-0.88; P = .02) with high accuracy.
Assessing rectal wall thickness at week 1 is valuable for predicting advanced therapy-induced CER and HEMI in patients with UC.
UMIN000032422 (https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi? recptno=R000036970).
肠道超声（IUS）是评估溃疡性结肠炎（UC）治疗短期反应的重要工具。然而，尚无关于在6 - 14周之前使用IUS预测长期内镜反应的报道。本研究评估了第1周时的IUS（经腹和经会阴）能否预测晚期治疗后的长期临床内镜缓解（CER）和组织学内镜黏膜改善（HEMI）。
这是一项前瞻性研究的事后分析，该前瞻性研究探讨了IUS在活动期UC患者晚期治疗开始时、第1周和第8周的预测价值。CER和HEMI根据14周后结肠镜检查评估的梅奥内镜亚评分和格博斯评分来定义。使用受试者工作特征分析评估IUS对CER和HEMI的预测价值。
69例患者中，15例（21%）达到CER，11例（16%）达到HEMI。在第1周时，CER组和HEMI组直肠肠壁厚度的减少（Δ直肠BWT）显著大于未出现这些改善的组（CER：1.1±0.7 vs -0.1±1.4，P <.01；HEMI：1.2±0.7 vs 0.0±1.4，P <.01）。然而，第8周时各组间的Δ直肠BWT无差异。第1周时的Δ直肠BWT能准确预测CER [曲线下面积（AUC）0.75；95%可信区间0.60 - 0.86；P =.02]和HEMI（AUC 0.79；95%可信区间0.65 - 0.88；P =.02），准确性较高。
评估第1周时的直肠壁厚度对预测UC患者晚期治疗诱导的CER和HEMI有价值。
UMIN000032422（https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000036970）
