Cerca
image du produit
Gastrointestinal Endoscopy

Abbonarsi

Novel endoscopic scoring system for immune mediated colitis: a multicenter retrospective study of 674 patients - 16/07/24

Doi : 10.1016/j.gie.2024.01.024 
Yinghong Wang, MD, PhD 1, ⁎ , Hamzah Abu-Sbeih, MD 1, 2, Tenglong Tang, MD 1, 3, Malek Shatila, MD 1, David Faleck, MD 4, Jessica Harris, MD 4, Michael Dougan, MD, PhD 5, Anna Olsson-Brown, MBChB, PhD 6, Douglas B. Johnson, MD, MSCI 7, Chanjuan Shi, MD, PhD 8, Petros Grivas, MD, PhD 9, Leonidas Diamantopoulos, MD 9, Dwight H. Owen, MD, MSc 10, Clarissa Cassol, MD 11, Christina A. Arnold, MD 12, David E. Warner, MD 13, Ajjai Alva, MD 13, Nick Powell, MBChB, PhD 14, Hajir Ibraheim, MBBS 14, Enrico N. De Toni, MD 15, Alexander B. Philipp, MD 15, Jessica Philpott, MD, PhD 16, Joseph Sleiman, MD 16, 17, Mark Lythgoe, MBBS 18, Ella Daniels, BMBS 19, Shahneen Sandhu, MBBS 20, Alison M. Weppler, MD, MPH 20, Andrew Buckle, PhD 20, David J. Pinato, MD, MRCP (UK), MRes, PhD 18, 21, Anusha Thomas, MD 1, Wei Qiao, PhD 22
1 Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA 
2 Department of Internal Medicine, University of Missouri, Kansas City, Missouri, USA 
3 Department of General Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China 
4 Gastroenterology, Hepatology and Nutrition Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA 
5 Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA 
6 The Clatterbridge Cancer Centre, Liverpool, UK 
7 Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA 
8 Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA 
9 Department of Medicine, Division of Oncology, University of Washington, Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA 
10 Division of Medical Oncology, The Ohio State University, Columbus, Ohio, USA 
11 Division of Renal Pathology, The Ohio State University, Columbus, Ohio, USA 
12 Division of Gastrointestinal and Liver Pathology, The Ohio State University, Columbus, Ohio, USA 
13 Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA 
14 Royal Marsden Hospital, and Guy’s and St Thomas’ Hospital, London, United Kingdom 
15 Department of Medicine II, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany 
16 Center for Inflammatory Bowel Disease, Cleveland Clinic, Cleveland, Ohio, USA 
17 Department of Gastroenterology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA 
18 Department of Surgery and Cancer, Imperial College London, London, United Kingdom 
19 Department of Oncology, Chelsea and Westminster Hospital, London, United Kingdom 
20 Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia 
21 Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy 
22 Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA 

∗Reprint requests: Yinghong Wang, MD, Department of Gastroenterology, Hepatology and Nutrition, Unit 1466, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.Department of GastroenterologyHepatology and NutritionUnit 1466The University of Texas MD Anderson Cancer Center1515 Holcombe BlvdHoustonTX77030USA

Abstract

Background and Aims

No endoscopic scoring system has been established for immune-mediated colitis (IMC). This study aimed to establish such a system for IMC and explore its utility in guiding future selective immunosuppressive therapy (SIT) use compared to clinical symptoms.

Methods

This retrospective, international, 14-center study included 674 patients who developed IMC after immunotherapy and underwent endoscopic evaluation. Ten endoscopic features were selected by group consensus and assigned 1 point each to calculate an IMC endoscopic score (IMCES). IMCES cutoffs were chosen to maximize specificity for SIT use. This specificity was compared between IMCESs, and clinical symptoms were graded according to a standardized instrument.

Results

A total of 309 (45.8%) patients received SIT. IMCES specificity for SIT use was 82.8% with a cutoff of 4. The inclusion of ulceration as a mandatory criterion resulted in higher specificity (85.0% for a cutoff of 4). In comparison, the specificity of a Mayo endoscopic subscore of 3 was 74.6%, and the specificity of clinical symptom grading was much lower at 27.4% and 12.3%, respectively. Early endoscopy was associated with timely SIT use (P < .001; r = 0.4084).

Conclusions

This is the largest multicenter study to devise an endoscopic scoring system to guide IMC management. An IMCES cutoff of 4 has a higher specificity for SIT use than clinical symptoms, supporting early endoscopic evaluation for IMC.

Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : CTCAEv5, IBD, ICI, IMC, IMCES, IQR, irAE, MES, PD-1/PD-L1, ROC, SIT


Mappa


© 2024  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
Aggiungere alla mia biblioteca Togliere dalla mia biblioteca Stampare
Esportazione

    Citazioni Export

  • File

    •

  • Contenuto

    •

Vol 100 - N° 2

P. 273 - agosto 2024 Ritorno al numero
Articolo precedente Articolo precedente
  • Use of pancreatic endotherapy in patients with chronic pancreatitis: results from a multicenter cohort study in the United States
  • Samuel Han, Darwin L. Conwell, Jeffrey J. Easler, Yunlong Yang, Dana K. Andersen, William E. Fisher, Evan L. Fogel, Chris Forsmark, Phil A. Hart, Steven J. Hughes, Liang Li, Stephen J. Pandol, Walter G. Park, Jose Serrano, Stephen K. Van Den Eeden, Santhi Swaroop Vege, Dhiraj Yadav, Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer
| Articolo seguente Articolo seguente
  • Histopathologic vertical margin positivity in cold snare polypectomy and mucosal resection for sessile serrated lesions
  • Koichi Hamada, Michitaka Honda, Yoshinori Horikawa, Yoshiki Shiwa, Kae Techigawara, Takayuki Nagahashi, Masafumi Ishikawa, Yuki Takeda, Daizo Fukushima, Noriyuki Nishino, Noriyuki Uesugi, Masamichi Suzuki, Tamotsu Sugai

Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.

Già abbonato a @@106933@@ rivista ?

@@150455@@ Voir plus

Il mio account

Aide & support

Dichiarazione CNIL

EM-CONSULTE.COM è registrato presso la CNIL, dichiarazione n. 1286925.

Ai sensi della legge n. 78-17 del 6 gennaio 1978 sull'informatica, sui file e sulle libertà, Lei puo' esercitare i diritti di opposizione (art.26 della legge), di accesso (art.34 a 38 Legge), e di rettifica (art.36 della legge) per i dati che La riguardano. Lei puo' cosi chiedere che siano rettificati, compeltati, chiariti, aggiornati o cancellati i suoi dati personali inesati, incompleti, equivoci, obsoleti o la cui raccolta o di uso o di conservazione sono vietati.
Le informazioni relative ai visitatori del nostro sito, compresa la loro identità, sono confidenziali.
Il responsabile del sito si impegna sull'onore a rispettare le condizioni legali di confidenzialità applicabili in Francia e a non divulgare tali informazioni a terzi.

Tutto il contenuto di questo sito: Copyright © 2026 Elsevier, i suoi licenziatari e contributori. Tutti i diritti sono riservati. Inclusi diritti per estrazione di testo e di dati, addestramento dell’intelligenza artificiale, e tecnologie simili. Per tutto il contenuto ‘open access’ sono applicati i termini della licenza Creative Commons.