A Simple Noninvasive Score Predicts Disease Activity and Deep Remission in Ulcerative Colitis

Abstract

Background: There is a need to use noninvasive markers in refining the management of ulcerative colitis to reduce the number of unnecessary colonoscopies, which facilitates the follow-up of activity and the response to treatment. Aim: Postulation of a sensitive, specific, simple and noninvasive score to monitor disease activity in ulcerative colitis. Methods: A case-control study was conducted: 168 patients with ulcerative colitis, 40 healthy individuals, and 60 patients for validation. Patients were divided into new diagnosis (n = 50), clinical remission (n = 60), and relapse (n = 58). The main outcome measures if the score correlates with clinical, endoscopic and histopathological characteristics and if it correlates with deep remission. Results: A scoring system was established composed of lactoferrin at a cutoff of 148.5 μg/mL, neutrophil lymphocyte ratio at a cutoff of 2.35, erythrocyte sedimentation rate at the first hour at a cutoff of 29.5 mm/h, C-reactive protein at a cutoff of 3.85 mg/L, mean platelet volume at a cutoff of 8.8 fL, fecal white blood cells at a cutoff of 9 cells/HPF, and fecal red blood cells at a cutoff of 6 cells/HPF. A score ≥5 can detect 94% of cases of UC as determined by the receiver operating characteristic curve with a sensitivity of 94% and a specificity 100%, AUC 0.92, SE 0.05, p = 0.001, 95% CI 0.82–1.1. In the validation group, it identified severely affected patients with a sensitivity of 95% and a specificity of 85.7%. Conclusions: This easily applied and reproducible noninvasive activity score showed high performance in predicting disease activity and deep remission in ulcerative colitis.

Inflammatory Bowel Disease and Neutrophil–Lymphocyte Ratio: A Systematic Scoping Review

“…Using a newly developed “noninvasive activity score”, Hanafy et al [ 82 ] reported NLR was higher in newly diagnosed patients with UC or in relapse, compared to patients in remission.…”

“…UC: NLR was assessed to potentially differentiate patients with active UC from patients with inactive UC in the following studies: Hanafy et al [ 82 ]—cutpoint at 2.35 (74.0% sensitivity, 86.0% specificity) Demir et al [ 62 ]—cutpoint at 2.39 (48.6% sensitivity, 77.5% specificity) Chen et al (2020) [ 37 ]—cutpoint at 2.40 (76.2% sensitivity, 84.5% specificity) Celikbilek et al [ 60 ]—cutpoint at 2.47 (53.9% sensitivity, 63.2% specificity) Acarturk et al [ 35 ]—cutpoint at 3.1 (78.0% sensitivity, 69.0% specificity, p < 0.001) Zhang et al (2017) [ 56 ]—cutpoint at 3.29 (47.4% sensitivity, 93.9% specificity) Dong et al [ 63 ]—cutpoint at 4.70 (61.0% sensitivity, 86.0% specificity) …”

Impact of the myosin heavy chain 9 gene single nucleotide polymorphism on inflammatory bowel disease

“…However, based upon the disease severity this change in the BMI could be insigni cant. As reported by Hanafy et al (2018) who reported that the mean values of the body mass index for the IBD and controls (11).…”

Peripheral blood miR‑372 as a biomarker for ulcerative colitis via direct targeting of NLRP12

“…Blood samples for the measurement of high-sensitivity C-reactive protein (CRP) were taken 1 week prior to or after endoscopy. CRP was measured using a nephelometric method (18). In brief, human CRP reacted with the corresponding antisera in the liquid phase to generate antigen-antibody complexes and produce turbidity using a CRP immunoturbidimetric assay kit [DiaSys Diagnostic Systems (Shanghai) Co., Ltd., Shanghai, China] according to the manufacturer's protocol.…”

“…The turbidity was associated with the antigen content and the CRP content in the sample was calculated by comparing the samples with PBS using Detection system 1 Hitachi 7600-020 automatic biochemical analyzer (Hitachi, Ltd., Tokyo, Japan). In healthy people, blood CRP levels are <5 mg/l (18). To avoid bias, all gastroenterologists performing the endoscopies were unaware of the results from the disease activity index.…”