Confocal laser endomicroscopy: a novel method for prediction of relapse in Crohn's disease
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Confocal laser endomicroscopy : a novel method for prediction of relapse in Crohn's disease. / Karstensen, John Gásdal; Săftoiu, Adrian; Brynskov, Jørn; Hendel, Jakob; Klausen, Pia; Cârtână, Tatiana; Klausen, Tobias Wirenfeldt; Riis, Lene Buhl; Vilmann, Peter.
I: Endoscopy, Bind 48, Nr. 4, 04.2016, s. 364-372.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Confocal laser endomicroscopy
T2 - a novel method for prediction of relapse in Crohn's disease
AU - Karstensen, John Gásdal
AU - Săftoiu, Adrian
AU - Brynskov, Jørn
AU - Hendel, Jakob
AU - Klausen, Pia
AU - Cârtână, Tatiana
AU - Klausen, Tobias Wirenfeldt
AU - Riis, Lene Buhl
AU - Vilmann, Peter
N1 - © Georg Thieme Verlag KG Stuttgart · New York.
PY - 2016/4
Y1 - 2016/4
N2 - BACKGROUND AND STUDY AIMS: Confocal laser endomicroscopy (CLE) has been shown to predict relapse in ulcerative colitis in remission, but little is currently known about its role in Crohn's disease. The aim of this study was to identify reproducible CLE features in patients with Crohn's disease and to examine whether these are risk factors for relapse.PATIENTS AND METHODS: This was a single-center prospective feasibility study of CLE imaging in patients with Crohn's disease. CLE imaging was performed in the terminal ileum and four colorectal sites, and was correlated with histopathology and macroscopic appearance. Clinical relapse, defined as the need for treatment escalation or surgical intervention, was recorded during follow-up.RESULTS: The study included 50 patients: 39 with Crohn's disease (20 in remission), and 11 controls. Ileal fluorescein leakage and microerosions were significantly more frequent in patients with endoscopically active Crohn's disease compared with patients with inactive Crohn's disease and controls (P = 0.005 and (P = 0.006, respectively). The same applied to colorectal fluorescein leakage and vascular alterations ((P = 0.043 and (P = 0.034, respectively). During a 12-month follow-up period, ileal fluorescein leakage and microerosions were significant risk factors for relapse in the subgroup of patients in remission (log rank (P = 0.009 and (P = 0.007, respectively) as well as in the entire group of patients with Crohn's disease (log rank (P = 0.006 and (P = 0.01, respectively). Inter- and intraobserver reproducibility was almost perfect (κ > 0.80) or substantial (κ > 0.60) for the majority of CLE parameters.CONCLUSIONS: CLE can identify reproducible microscopic changes in the terminal ileum that are risk factors for relapse in patients with otherwise inactive Crohn's disease.TRIAL REGISTRATION: ClinicalTrials.gov (NCT01738529).
AB - BACKGROUND AND STUDY AIMS: Confocal laser endomicroscopy (CLE) has been shown to predict relapse in ulcerative colitis in remission, but little is currently known about its role in Crohn's disease. The aim of this study was to identify reproducible CLE features in patients with Crohn's disease and to examine whether these are risk factors for relapse.PATIENTS AND METHODS: This was a single-center prospective feasibility study of CLE imaging in patients with Crohn's disease. CLE imaging was performed in the terminal ileum and four colorectal sites, and was correlated with histopathology and macroscopic appearance. Clinical relapse, defined as the need for treatment escalation or surgical intervention, was recorded during follow-up.RESULTS: The study included 50 patients: 39 with Crohn's disease (20 in remission), and 11 controls. Ileal fluorescein leakage and microerosions were significantly more frequent in patients with endoscopically active Crohn's disease compared with patients with inactive Crohn's disease and controls (P = 0.005 and (P = 0.006, respectively). The same applied to colorectal fluorescein leakage and vascular alterations ((P = 0.043 and (P = 0.034, respectively). During a 12-month follow-up period, ileal fluorescein leakage and microerosions were significant risk factors for relapse in the subgroup of patients in remission (log rank (P = 0.009 and (P = 0.007, respectively) as well as in the entire group of patients with Crohn's disease (log rank (P = 0.006 and (P = 0.01, respectively). Inter- and intraobserver reproducibility was almost perfect (κ > 0.80) or substantial (κ > 0.60) for the majority of CLE parameters.CONCLUSIONS: CLE can identify reproducible microscopic changes in the terminal ileum that are risk factors for relapse in patients with otherwise inactive Crohn's disease.TRIAL REGISTRATION: ClinicalTrials.gov (NCT01738529).
KW - Adult
KW - Aged
KW - Colon
KW - Colonoscopy
KW - Crohn Disease
KW - Feasibility Studies
KW - Female
KW - Fluorescein
KW - Fluorescent Dyes
KW - Humans
KW - Ileum
KW - Intestinal Mucosa
KW - Male
KW - Microscopy, Confocal
KW - Middle Aged
KW - Predictive Value of Tests
KW - Prospective Studies
KW - Rectum
KW - Recurrence
KW - Reproducibility of Results
KW - Risk Factors
KW - Journal Article
KW - Randomized Controlled Trial
KW - Research Support, Non-U.S. Gov't
U2 - 10.1055/s-0034-1393314
DO - 10.1055/s-0034-1393314
M3 - Journal article
C2 - 26583952
VL - 48
SP - 364
EP - 372
JO - Endoscopy
JF - Endoscopy
SN - 0013-726X
IS - 4
ER -
ID: 179879618