Combination of serological biomarkers and clinical features to predict mucosal healing in Crohn’s disease: a multicenter cohort study
Abstract Purpose Mucosal healing (MH) has become the treatment goal of patients with Crohn’s disease (CD). This study aims to develop a noninvasive and reliable clinical tool for individual evaluation of mucosal healing in patients with Crohn’s disease. Methods A multicenter retrospective cohort was...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-05-01
|
| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-022-02304-y |
| _version_ | 1818203027472908288 |
|---|---|
| author | Nana Tang Han Chen Ruidong Chen Wen Tang Hongjie Zhang |
| author_facet | Nana Tang Han Chen Ruidong Chen Wen Tang Hongjie Zhang |
| author_sort | Nana Tang |
| collection | DOAJ |
| description | Abstract Purpose Mucosal healing (MH) has become the treatment goal of patients with Crohn’s disease (CD). This study aims to develop a noninvasive and reliable clinical tool for individual evaluation of mucosal healing in patients with Crohn’s disease. Methods A multicenter retrospective cohort was established. Clinical and serological variables were collected. Separate risk factors were incorporated into a binary logistic regression model. A primary model and a simple model were established, respectively. The model performance was evaluated with C-index, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Internal validation was performed in patients with small intestinal lesions. Results A total of 348 consecutive patients diagnosed with CD who underwent endoscopic examination and review after treatment from January 2010 to June 2021 were composed in the derivation cohort, and 112 patients with small intestinal lesions were included in the validation cohort. The following variables were independently associated with the MH and were subsequently included into the primary prediction model: PLR (platelet to lymphocyte ratio), CAR (C-reactive protein to albumin ratio), ESR (erythrocyte sedimentation rate), HBI (Harvey-Bradshaw Index) score and infliximab treatment. The simple model only included factors of PLR, CAR and ESR. The primary model performed better than the simple one in C-index (87.5% vs. 83.0%, p = 0.004). There was no statistical significance between these two models in sensitivity (70.43% vs. 62.61%, p = 0.467), specificity (87.12% vs. 80.69%, p = 0.448), PPV (72.97% vs. 61.54%, p = 0.292), NPV (85.65% vs. 81.39%, p = 0.614), and accuracy (81.61% vs. 74.71%, p = 0.303). The primary model had good calibration and high levels of explained variation and discrimination in validation cohort. Conclusions This model can be used to predict MH in post-treatment patients with CD. It can also be used as an indication of endoscopic surveillance to evaluate mucosal healing in patients with CD after treatment. |
| first_indexed | 2024-12-12T03:18:49Z |
| format | Article |
| id | doaj.art-16ffbaf071624786b8b07fd9a8a2689d |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-12T03:18:49Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-16ffbaf071624786b8b07fd9a8a2689d2022-12-22T00:40:13ZengBMCBMC Gastroenterology1471-230X2022-05-012211810.1186/s12876-022-02304-yCombination of serological biomarkers and clinical features to predict mucosal healing in Crohn’s disease: a multicenter cohort studyNana Tang0Han Chen1Ruidong Chen2Wen Tang3Hongjie Zhang4Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanjing Medical UniversityDepartment of Gastroenterology, The Second Affiliated Hospital of Soochow UniversityDepartment of Gastroenterology, The Second Affiliated Hospital of Soochow UniversityDepartment of Gastroenterology, The First Affiliated Hospital of Nanjing Medical UniversityAbstract Purpose Mucosal healing (MH) has become the treatment goal of patients with Crohn’s disease (CD). This study aims to develop a noninvasive and reliable clinical tool for individual evaluation of mucosal healing in patients with Crohn’s disease. Methods A multicenter retrospective cohort was established. Clinical and serological variables were collected. Separate risk factors were incorporated into a binary logistic regression model. A primary model and a simple model were established, respectively. The model performance was evaluated with C-index, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy. Internal validation was performed in patients with small intestinal lesions. Results A total of 348 consecutive patients diagnosed with CD who underwent endoscopic examination and review after treatment from January 2010 to June 2021 were composed in the derivation cohort, and 112 patients with small intestinal lesions were included in the validation cohort. The following variables were independently associated with the MH and were subsequently included into the primary prediction model: PLR (platelet to lymphocyte ratio), CAR (C-reactive protein to albumin ratio), ESR (erythrocyte sedimentation rate), HBI (Harvey-Bradshaw Index) score and infliximab treatment. The simple model only included factors of PLR, CAR and ESR. The primary model performed better than the simple one in C-index (87.5% vs. 83.0%, p = 0.004). There was no statistical significance between these two models in sensitivity (70.43% vs. 62.61%, p = 0.467), specificity (87.12% vs. 80.69%, p = 0.448), PPV (72.97% vs. 61.54%, p = 0.292), NPV (85.65% vs. 81.39%, p = 0.614), and accuracy (81.61% vs. 74.71%, p = 0.303). The primary model had good calibration and high levels of explained variation and discrimination in validation cohort. Conclusions This model can be used to predict MH in post-treatment patients with CD. It can also be used as an indication of endoscopic surveillance to evaluate mucosal healing in patients with CD after treatment.https://doi.org/10.1186/s12876-022-02304-yCrohn’s diseaseMucosal healingNomogramPLREndoscopic |
| spellingShingle | Nana Tang Han Chen Ruidong Chen Wen Tang Hongjie Zhang Combination of serological biomarkers and clinical features to predict mucosal healing in Crohn’s disease: a multicenter cohort study BMC Gastroenterology Crohn’s disease Mucosal healing Nomogram PLR Endoscopic |
| title | Combination of serological biomarkers and clinical features to predict mucosal healing in Crohn’s disease: a multicenter cohort study |
| title_full | Combination of serological biomarkers and clinical features to predict mucosal healing in Crohn’s disease: a multicenter cohort study |
| title_fullStr | Combination of serological biomarkers and clinical features to predict mucosal healing in Crohn’s disease: a multicenter cohort study |
| title_full_unstemmed | Combination of serological biomarkers and clinical features to predict mucosal healing in Crohn’s disease: a multicenter cohort study |
| title_short | Combination of serological biomarkers and clinical features to predict mucosal healing in Crohn’s disease: a multicenter cohort study |
| title_sort | combination of serological biomarkers and clinical features to predict mucosal healing in crohn s disease a multicenter cohort study |
| topic | Crohn’s disease Mucosal healing Nomogram PLR Endoscopic |
| url | https://doi.org/10.1186/s12876-022-02304-y |
| work_keys_str_mv | AT nanatang combinationofserologicalbiomarkersandclinicalfeaturestopredictmucosalhealingincrohnsdiseaseamulticentercohortstudy AT hanchen combinationofserologicalbiomarkersandclinicalfeaturestopredictmucosalhealingincrohnsdiseaseamulticentercohortstudy AT ruidongchen combinationofserologicalbiomarkersandclinicalfeaturestopredictmucosalhealingincrohnsdiseaseamulticentercohortstudy AT wentang combinationofserologicalbiomarkersandclinicalfeaturestopredictmucosalhealingincrohnsdiseaseamulticentercohortstudy AT hongjiezhang combinationofserologicalbiomarkersandclinicalfeaturestopredictmucosalhealingincrohnsdiseaseamulticentercohortstudy |