Assessment of Crohn's disease activity by confocal laser endomicroscopy
Assessment of Crohn's disease activity by confocal laser endomicroscopy
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DOI：
10.1002/ibd.22907
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发表时间：
2012-12-01
影响因子：
4.9
通讯作者：
Mudter, Jonas
中科院分区：
文献类型：
--
作者：
Neumann, Helmut;Vieth, Michael;Mudter, Jonas
背景：共聚焦激光显微内镜（CLE）允许在进行内窥镜检查期间在肠道粘膜层内进行显微成像。不同的研究已经解决了CLE用于溃疡性结肠炎和显微镜下结肠炎的体内诊断的潜力。然而，还没有关于CLE用于克罗恩病（CD）的体内诊断的数据。目的是评估CLE在CD患者中的临床效用，并确定疾病活动是否可以使用CLE.Methods进行分级：入选了有和无CD的连续性患者。通过标准白光内窥镜检查结肠粘膜，然后进行CLE。CD患者和对照组的CLE上看到的功能进行了比较。结果：在所有，76例CD患者进行了筛选，其中54例患者被纳入本研究。18例无炎症性肠病（IBD）的患者作为对照。活动性CD患者中结肠隐窝迂曲度增加、隐窝腔扩大、微糜烂、血管化增强和固有层内细胞浸润增加的比例显著较高。在静止CD，隐窝和杯状细胞的数量显着增加，检测到与对照组相比。根据我们的研究结果，我们提出了一个克罗恩病内镜活动评分（CDEAS）评估CD activityinvivo.Conclusions：CLE有可能显着提高诊断CD相比，标准的内窥镜检查。这些发现应该在未来的前瞻性试验中进行评估，以评估这种新开发的CLE评分对疾病病程和治疗反应的预测价值。（Inflamm Bowel Dis 2012;）
Background: Confocal laser endomicroscopy (CLE) allows microscopic imaging within the mucosal layer of the gut during ongoing endoscopy. Different studies have addressed the potential of CLE for in vivo diagnosis of ulcerative colitis and microscopic colitis. However, there are no data on the utility of CLE for in vivo diagnosis of Crohn's disease (CD). The aim was to assess the clinical utility of CLE in patients with CD and to determine whether disease activity can be graded using CLE.Methods: Consecutive patients with and without CD were enrolled. The colonic mucosa was examined by standard white-light endoscopy followed by CLE. The features seen on CLE were compared between CD patients and controls.Results: In all, 76 patients with CD were screened, of whom 54 patients were included in the present study. Eighteen patients without inflammatory bowel disease (IBD) served as controls. A significantly higher proportion of patients with active CD had increased colonic crypt tortuosity, enlarged crypt lumen, microerosions, augmented vascularization, and increased cellular infiltrates within the lamina propria. In quiescent CD, a significant increase in crypt and goblet cell number was detected compared with controls. Based on our findings, we propose a Crohn's Disease Endomicroscopic Activity Score (CDEAS) for assessing CD activity in vivo.Conclusions: CLE has the potential to significantly improve diagnosis of CD compared with standard endoscopy. These findings should be evaluated in future prospective trials to assess the value of this newly developed CLE score for prediction of disease course and therapeutic responses. (Inflamm Bowel Dis 2012;)