Low predictive value of histopathological scoring system for complications development in children with Crohn’s disease

2017 ◽  
Vol 213 (4) ◽  
pp. 353-358 ◽  
Author(s):  
Ondrej Fabian ◽  
Ondrej Hradsky ◽  
Kristyna Potuznikova ◽  
Alena Kalfusova ◽  
Lenka Krskova ◽  
...  
2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S432-S433
Author(s):  
T Omori ◽  
H Kambayashi ◽  
S Murasugi ◽  
A Ito ◽  
M Yonezawa ◽  
...  

Abstract Background Crohn’s disease (CD) is a pathological condition that develops because of inflammatory and organic changes such as stenosis. The Lewis Score (LS) and Capsule Endoscopy Crohn’s Disease Activity Index (CECDAI) are employed for scoring small bowel lesions in CD using small bowel capsule endoscopy (SBCE). However, it remains unclear whether the obtained score can contribute to the understanding of the disease state or the selection of treatment. This study aimed to examine whether the existing scoring systems (LS and CECDAI) and the new Crohn’s Disease Activity in Capsule Endoscopy (CDACE) scoring system proposed by us were useful in understanding the disease state of CD. Methods After obtaining the results of intestinal patency evaluations using patency capsules from June 2012 to June 2018, 196 times (108 CD patients) who underwent SBCE were included in this retrospective study. The cut-off values of LS, CECDAI, and CDACE were calculated using the receiver operating characteristic curve to determine the extent of small intestinal lesions and the presence or absence of stenotic lesions. Using the cut-off values, the sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of each scoring system were determined. In CDACE, the small bowel is divided into quartiles, and the degree of inflammation (range: 0–4) for each quantile (range: 0–16) (inflammation score: A), number of quartiles with inflammation (range: 0–4) (range score: B), and degree of stenosis (range: 0–3) (stenosis score: C) were scored; the CDACE score was calculated as follows: A × 100 + B × 10 + C (score range: 0–1643). Results For LS, the Se, Sp, PPV, and NPV were 83.7%, 73.5%, 75.9%, and 81.8%, respectively, for inflammation in multiple quantiles (2/3 quantiles or more) (cut-off value: 10) and 94.9%, 90.5%, 71.2%, and 98.6%, respectively, with regard to the presence or absence of stenosis (cut-off value: 196). For CECDAI, the Se, Sp, PPV, and NPV were 93.8%, 86.1%, 82.6%, and 93.4%, respectively, for multiple quantiles (both proximal and distal) (cut-off value: 5) and 51.3%, 87.9%, 51.3%, and 87.9%, respectively, with regard to the presence or absence of stenosis (cut-off value: 11). For CDACE, the Se, Sp, PPV, and NPV were 100%, 82.4%, 78.6%, and 100%, respectively, for multiple quantiles (multiple locations excluding two consecutive zones) (cut-off value: 320) and presence or absence of stenosis was identified in the first digit. Conclusion CECDAI was more likely to predict the extent of inflammation than LS, although it was difficult to determine the presence or absence of stenosis. Based on the scores, CDACE may be a useful scoring system in clinical practice where the disease state of CD needs to be determined.


2019 ◽  
Vol 17 (8) ◽  
pp. 1643-1645 ◽  
Author(s):  
Pauline Rivière ◽  
Séverine Vermeire ◽  
Marie Irles-Depe ◽  
Gert Van Assche ◽  
Paul Rutgeerts ◽  
...  

2021 ◽  
Author(s):  
Kristyna Zarubova ◽  
Ondrej Fabian ◽  
Ondrej Hradsky ◽  
Tereza Lerchova ◽  
Filip Mikus ◽  
...  

2015 ◽  
Vol 21 (22) ◽  
pp. 6952-6964 ◽  
Author(s):  
Nora Sipeki ◽  
Laszlo Davida ◽  
Eszter Palyu ◽  
Istvan Altorjay ◽  
Jolan Harsfalvi ◽  
...  

2014 ◽  
Vol 8 (9) ◽  
pp. 1022-1029 ◽  
Author(s):  
Graham D. Naismith ◽  
Lyn A. Smith ◽  
Sarah J.E. Barry ◽  
Joanna I. Munro ◽  
Susan Laird ◽  
...  

Abstract Background Faecal calprotectin (FC) is a non-invasive marker of gastrointestinal inflammation. Aim To determine whether higher FC levels in individuals with quiescent Crohn's disease are associated with clinical relapse over the ensuing 12 months. Methods A single centre prospective study was undertaken in Crohn's disease patients in clinical remission. The receiver operating characteristic (ROC) curve for the primary endpoint of clinical relapse by 12 months, based on FC at baseline, was calculated. Kaplan–Meier curves of time to relapse were based on the resulting optimal FC cutoff for predicting relapse. Results Of 97 patients recruited, 92 were either followed up for 12 months without relapsing, or reached the primary endpoint within that period. Of these, 10 (11%) relapsed by 12 months. Median FC was lower for non-relapsers, 96 μg/g (IQR 39–237), than for relapsers, 414 μg/g (IQR 259–590), (p = 0.005). The area under the ROC curve to predict relapse using FC was 77.4%. An optimal cutoff FC value of 240 μg/g to predict relapse had sensitivity of 80.0% and specificity of 74.4%. Negative predictive value was 96.8% and positive predictive value was 27.6%, FC ≥ 240 μg/g was associated with likelihood of relapse by 12-months 12.18 (95%CI 2.55–58.2) times higher than lower values (p = 0.002). Conclusions In this prospective dataset, FC is a useful tool to help identify quiescent Crohn's disease patients at a low risk of relapse over the ensuing 12 months. FC of 240 μg/g was the optimal cutoff in this cohort.


Author(s):  
Mark T Osterman ◽  
Kelli L VanDussen ◽  
Ilyssa O Gordon ◽  
Elisabeth M Davis ◽  
Katherine Li ◽  
...  

Abstract Background Therapeutic efficacy of biologics has remained at about 50% for 2 decades. In Crohn’s disease (CD) patients, we examined the predictive value of an epithelial cell biomarker, ileal microvillar length (MVL), for clinical response to ustekinumab (UST) and vedolizumab (VDZ) and its relationship to another biomarker, intestinal epithelial cell (IEC) pyroptosis, with respect to response to VDZ. Method Ileal biopsies from the UNITI-2 randomized controlled trial were analyzed for MVL as a predictor of clinical response to UST. In a 5-center academic retrospective cohort of CD patients, ileal MVL was analyzed to determine its predictive value for response to VDZ. Correlation between ileal MVL and IEC pyroptosis was determined, and the discriminant ability of the combination of 2 biomarkers to VDZ was examined. Results Clinical response in UST was significantly higher than placebo (65% vs 39%; P = 0.03), with patients with normal MVL (>1.7 µm) having the greatest therapeutic effect: 85% vs 20% (P = 0.02). For VDZ, clinical response with MVL of 1.35 to 1.55 µm was 82% vs 44% (<1.35 µm) and 40% (>1.55 µm; P = 0.038). There was no correlation between ileal MVL and IEC pyroptosis. The combination criteria of ileal pyroptosis <14 positive cells/1000 IECs or MVL of 1.35 to 1.55 µm could identify 84% of responders and 67% of nonresponders (P = 0.001). Conclusion Ileal MVL was predictive of response to UST and VDZ in prospective and retrospective CD cohorts. It was independent of ileal IEC pyroptosis, and combination of the 2 biomarkers enhanced the discriminate ability of responders from nonresponders to VDZ.


2015 ◽  
Vol 30 (2) ◽  
pp. 286-291 ◽  
Author(s):  
Claudia Herrera-deGuise ◽  
Francesc Casellas ◽  
Virginia Robles ◽  
Ester Navarro ◽  
Natalia Borruel

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