Katrine Carlsen1,2, Lene Buhl Riis1, Henriette Elsberg3, Louise Maagaard3, Tine Thorkilgaard3, Sveinung Wergeland Sørbye4, Christian Jakobsen2, Vibeke Wewer2, Jon Florholmen5,6, Rasmus Goll5,6, Pia Munkholm7. 1. a Department of Pathology, Herlev and Gentofte Hospital , University of Copenhagen , Herlev , Denmark. 2. b Department of Pediatrics , Hvidovre University Hospital , Hvidovre , Denmark. 3. c Department of Gastroenterology, Herlev and Gentofte Hospital , University of Copenhagen , Herlev , Denmark. 4. d Department of Clinical Pathology , University Hospital of North Norway , Tromsø , Norway. 5. e Department of Gastroenterology , University Hospital of North Norway , Tromsø , Norway. 6. f Research Group Gastroenterology and Nutrition, Institute Clinical Medicine , UiT the Arctic University of Norway , Tromsø , Norway. 7. g Department of Gastroenterology , North Zealand Hospital, University of Copenhagen , Frederikssund , Denmark.
Abstract
BACKGROUND: Mucosal healing is proposed as treat-to-target in ulcerative colitis (UC), even though the definition of mucosal healing remains contested as it has been suggested to be assessed by either endoscopy, histology or both. However, all definitions require an endoscopic evaluation of the mucosa. As endoscopies are invasive and uncomfortable to the patient we aimed to calibrate noninvasive predictors of mucosal inflammatory status defined by both endoscopy and histology. METHODS: UC patients (n = 106) undergoing a sigmoid-/colonoscopy were prospectively included. Feces (fecal calprotectin, FC), blood samples (hemoglobin, C-reactive protein, orosomucoid, erythrocyte sedimentation rate, albumin) and symptom scores (Simple Clinical Colitis Activity Index, SSCAI) were collected and analyzed. The colonic mucosa was assessed by the Mayo endoscopic sub score and biopsies were obtained for a histologic grading by Geboes score. Predictive cutoff values were analyzed by receiver operating characteristics (ROC). A combined endoscopic and histologic assessment defined deep remission (Mayo =0 and Geboes ≤1) and activity (Mayo ≥2 and Geboes >3). RESULTS: Only FC showed a significant ROC curve (p < .05). We suggest FC (mg/kg) cutoffs for detection of following: Deep remission: FC ≤25; Indeterminate: FC 25-230 - an endoscopy is recommended if a comprehensive status of both endoscopic and histologic assessed activity is needed; Active disease: FC >230. The complete ROC data is presented, enabling extraction of an FC cutoff value's sensitivity and specificity. CONCLUSIONS: FC predicts endoscopic and histologic assessed deep remission and inflammatory activity of colon mucosa. Neither the markers in blood nor the SCCAI performed significant ROC results.
BACKGROUND: Mucosal healing is proposed as treat-to-target in ulcerative colitis (UC), even though the definition of mucosal healing remains contested as it has been suggested to be assessed by either endoscopy, histology or both. However, all definitions require an endoscopic evaluation of the mucosa. As endoscopies are invasive and uncomfortable to the patient we aimed to calibrate noninvasive predictors of mucosal inflammatory status defined by both endoscopy and histology. METHODS: UC patients (n = 106) undergoing a sigmoid-/colonoscopy were prospectively included. Feces (fecal calprotectin, FC), blood samples (hemoglobin, C-reactive protein, orosomucoid, erythrocyte sedimentation rate, albumin) and symptom scores (Simple Clinical Colitis Activity Index, SSCAI) were collected and analyzed. The colonic mucosa was assessed by the Mayo endoscopic sub score and biopsies were obtained for a histologic grading by Geboes score. Predictive cutoff values were analyzed by receiver operating characteristics (ROC). A combined endoscopic and histologic assessment defined deep remission (Mayo =0 and Geboes ≤1) and activity (Mayo ≥2 and Geboes >3). RESULTS: Only FC showed a significant ROC curve (p < .05). We suggest FC (mg/kg) cutoffs for detection of following: Deep remission: FC ≤25; Indeterminate: FC 25-230 - an endoscopy is recommended if a comprehensive status of both endoscopic and histologic assessed activity is needed; Active disease: FC >230. The complete ROC data is presented, enabling extraction of an FC cutoff value's sensitivity and specificity. CONCLUSIONS: FC predicts endoscopic and histologic assessed deep remission and inflammatory activity of colon mucosa. Neither the markers in blood nor the SCCAI performed significant ROC results.
Authors: Allison Ross Eckard; Heather Y Hughes; Nancy L Hagood; Mary Ann O'Riordan; Danielle Labbato; Julia C Kosco; Sarah E Scott; Grace A McComsey Journal: J Acquir Immune Defic Syndr Date: 2021-02-01 Impact factor: 3.771
Authors: Arno R Bourgonje; Julius Z H von Martels; Ruben Y Gabriëls; Tjasso Blokzijl; Manon Buist-Homan; Janette Heegsma; Bernadien H Jansen; Hendrik M van Dullemen; Eleonora A M Festen; Rinze W F Ter Steege; Marijn C Visschedijk; Rinse K Weersma; Paul de Vos; Klaas Nico Faber; Gerard Dijkstra Journal: Front Med (Lausanne) Date: 2019-11-05
Authors: Ludimilla Dos Reis Malvão; Kalil Madi; Barbara Cathalá Esberard; Renata Fernandes de Amorim; Kelly Dos Santos Silva; Katia Farias E Silva; Heitor Siffert Pereira de Souza; Ana Teresa Pugas Carvalho Journal: Medicine (Baltimore) Date: 2021-01-22 Impact factor: 1.889