Predicting Mucosal Healing in Crohn's Disease Using Practical Clinical Indices with Regard to the Location of Active Disease
Bamba, S.; Tsujikawa, T.; Ban, H.; Imaeda, H.; Inatomi, O.; Nishida, A.; Sasaki, M.; Andoh, A.; Fujiyama, Y.
Hepato-Gastroenterology 61(131): 689-696
2014
ISSN/ISBN: 0172-6390 PMID: 26176058 Document Number: 16762
Only a few reports have examined the relationship between balloon-assisted enteroscopy (BAE)-based mucosal lesion severity in Crohn's disease (CD) using clinical variables such as serum levels of disease activity markers and Crohn's Disease Activity Index. We analysed whether clinical variables are useful for predicting mucosal healing (MH) in various CD types. A total of 173 CD patients who underwent BAE were enrolled. Endoscopic findings were assessed using the modified Rutgeerts score (MRS). In this study, all observed samples of intestine, small bowel and large bowel were individually scored. The 'ileum group' included patients with MRS ileum scores greater than or equal to MRS colon scores (n = 139), whereas the 'colon group' included patients who had colon scores greater than or equal to MRS ileum scores (n = 56). Spearman's rank correlation between MRS and practical clinical parameters was stronger in the colon group than in the ileum group. Receiver operating characteristic analysis revealed that the colon group had better correlativity for MH prediction than the ileum group. The MH index using C-reactive protein and serum albumin obtained from logistic regression analysis improved the accuracy of MH prediction by 74.3%. A combination of serum albumin and C-reactive protein is useful for MH prediction. However, the reliability of MH prediction can differ depending on the dominant area of the mucosal lesions.
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