Adequacy of sigmoidoscopy as compared to colonoscopy for assessment of disease activity in patients of ulcerative colitis: a prospective study.

IF 3.4 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2024-07-01 Epub Date: 2024-05-16 DOI:10.5217/ir.2023.00174

Sameet Tariq Patel, Anuraag Jena, Sanjay Chandnani, Shubham Jain, Pankaj Nawghare, Saurabh Bansal, Harsh Gandhi, Rishikesh Malokar, Jay Chudasama, Prasanta Debnath, Seemily Kahmei, Rima Kamat, Sangeeta Kini, Qais Q Contractor, Pravin M Rathi

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引用次数: 0

Abstract

Background/aims: Patients of ulcerative colitis (UC) on follow-up are routinely evaluated by sigmoidoscopy. There is no prospective literature to support this practice. We assessed agreement between sigmoidoscopy and colonoscopy prospectively in patients with disease extent beyond the sigmoid colon.

Methods: We conducted a prospective observational study at a tertiary care institute for agreement between sigmoidoscopy and colonoscopy. We assessed endoscopic activity using the Mayo Endoscopic Score (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and histological activity using the Nancy Index (NI), Robarts Histopathology Index (RHI), and Simplified Geboes Score (SGS).

Results: Sigmoidoscopy showed a strong agreement with colonoscopy for MES and UCEIS with a kappa (κ) of 0.96 and 0.94 respectively. The misclassification rate for MES and UCEIS was 3% and 5% respectively. Sigmoidoscopy showed perfect agreement (κ = 1.00) with colonoscopy for assessment of the presence of endoscopic activity in the colon using MES ≥ 1 as activity criteria and strong agreement (κ = 0.93) using MES > 1 as activity criteria. Sigmoidoscopy showed strong agreement with colonoscopy for assessment of the presence of endoscopic activity using UCEIS (κ = 0.92). Strong agreement was observed between sigmoidoscopy and colonoscopy using NI (κ = 0.86), RHI (κ = 1.00), and SGS (κ = 0.92) for the detection of histological activity. The misclassification rate for the detection of histological activity was 2%, 0%, and 1% for NI, RHI, and SGS respectively.

Conclusions: Sigmoidoscopy showed strong agreement with colonoscopy for endoscopic and histologic disease activity. Sigmoidoscopy is adequate for assessment of disease activity in patients with UC during follow-up evaluation.

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在评估溃疡性结肠炎患者的疾病活动性时，乙状结肠镜检查与结肠镜检查相比是否足够：一项前瞻性研究。

背景/目的：对溃疡性结肠炎（UC）患者进行随访时，通常都要进行乙状结肠镜检查。目前还没有前瞻性文献支持这种做法。我们对疾病范围超过乙状结肠的患者进行了乙状结肠镜检查和结肠镜检查的一致性前瞻性评估：我们在一家三级医疗机构开展了一项前瞻性观察研究，以评估乙状结肠镜检查和结肠镜检查之间的一致性。我们使用梅奥内镜评分（MES）和溃疡性结肠炎内镜严重程度指数（UCEIS）评估内镜活动度，使用南希指数（NI）、罗巴特组织病理学指数（RHI）和简化吉布斯评分（SGS）评估组织学活动度：乙状结肠镜检查与结肠镜检查在 MES 和 UCEIS 方面显示出很高的一致性，卡帕（K）分别为 0.96 和 0.94。MES和UCEIS的误诊率分别为3%和5%。乙状结肠镜检查与结肠镜检查在以 MES ?1 为活动标准评估结肠是否存在内镜活动方面显示出完美的一致性（K = 1.00），而以 MES > 1 为活动标准则显示出很强的一致性（K = 0.93）。乙状结肠镜与结肠镜在使用 UCEIS 评估是否存在内镜活动方面显示出很高的一致性（K = 0.92）。使用 NI（K = 0.86）、RHI（K = 1.00）和 SGS（K = 0.92）检测组织学活动性时，乙状结肠镜检查和结肠镜检查之间的一致性很高。NI、RHI和SGS检测组织学活动的误判率分别为2%、0%和1%：结论：乙状结肠镜检查与结肠镜检查在内镜和组织学疾病活动性方面显示出很强的一致性。乙状结肠镜检查足以在随访评估期间评估 UC 患者的疾病活动性。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.