A Serum Biomarker Panel Can Accurately Identify Mucosal Ulcers in Patients With Crohn's Disease.
A Serum Biomarker Panel Can Accurately Identify Mucosal Ulcers in Patients With Crohn's Disease.
复制标题
血清生物标志物组可以准确识别克罗恩病患者的粘膜溃疡。
DOI：
10.1093/ibd/izac117
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发表时间：
2023
影响因子：
4.9
通讯作者：
Dulai,ParambirS
中科院分区：
文献类型：
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作者：
Holmer,ArielaK;Boland,BrigidS;Singh,Siddharth;Neill,Jennifer;Le,Helen;Miralles,Ara;Collins,AngelinaE;Sandborn,WilliamJ;Dulai,ParambirS
背景内镜愈合指数（EHI）是一种血清生物标志物，可以预测克罗恩病（CD）患者的内镜炎症。方法对参与前瞻性生物样本库（2014年6月至2018年12月）的成年患者的内镜检查血清样本进行事后分析。使用先前确定的临界值，根据CD简易内镜评分的单个参数评估EHI的诊断性能。EHI性能的混杂因素进行了确定使用logistic regression.ResultsA共205 CD患者（50%男性，中位年龄37岁）。20分的EHI对于排除任何溃疡（85%; 95%置信区间[CI]，77%-91%）和大（5-20 mm）或非常大（>20 mm）溃疡（93%; 95% CI，84%-97%）是敏感的。50分的EHI专门用于裁定任何溃疡（86%; 95% CI，76%-92%）和大或非常大的溃疡（87%; 95% CI，79%-92%）。占总程度的粘膜炎症，狭窄，疾病的位置，EHI每增加20点与1.7倍的概率增加的存在大或非常大的溃疡（调整后的比值比，1.7; 95%CI，1.1-2.6）。50分的临界值可以可靠地控制粘膜溃疡，并允许治疗调整。20分的临界值可以可靠地排除粘膜溃疡，并表示治疗调整算法完成。
BackgroundThe Endoscopic Healing Index (EHI) is a serum biomarker panel that can predict endoscopic inflammation in Crohn’s disease (CD).MethodsPaired serum samples with endoscopies from adult patients participating in a prospective biobank (June 2014 to December 2018) were analyzed post hoc. Diagnostic performance for EHI was assessed against the individual parameters of the Simple Endoscopic Score for CD using previously identified cutoffs. Confounders for EHI performance were identified using logistic regression.ResultsA total of 205 CD patients were included (50% male, median age 37 years). An EHI of 20 points was sensitive for ruling out any ulcers (85%; 95% confidence interval [CI], 77%-91%) and large (5-20 mm) or very large (>20 mm) ulcers (93%; 95% CI, 84%-97%). An EHI of 50 points was specific for ruling in any ulcers (86%; 95% CI, 76%-92%) and large or very large ulcers (87%; 95% CI, 79%-92%). After accounting for total extent of inflamed mucosa, strictures, and disease location, each 20-point increase in EHI was associated with a 1.7-fold increased probability for the presence of large or very large ulcers (adjusted odds ratio, 1.7; 95% CI, 1.1-2.6).ConclusionsThe EHI was independently associated with ulcer size and accurately identified large or very large ulcers. A cutoff of 50 points can reliably rule in mucosal ulcers and allow for treatment adjustment. A cutoff of 20 points can reliably rule out mucosal ulcers and signal completion of treatment adjustment algorithms.