S1440 The Cecal Patch in Ulcerative Proctitis – A Harbinger of Disease Progression or Merely an Incidental Finding?
Notice bibliographique
Résumé
Introduction: Ulcerative colitis classically consists of immune-mediated inflammation that is present in the rectum and can extend proximally in a continuous matter. Isolated rectal inflammation, or ulcerative proctitis, represents a limited form of disease that is not associated with increased risk of dysplasia. Existing literature is sparse and conflicting on the significance of peri-appendiceal inflammation, or a “cecal patch”, in otherwise isolated proctitis. Our aim was to assess if the presence of a cecal patch carried a higher risk of disease progression or complications. Methods: This is a single-center retrospective study of adult patients with ulcerative proctitis treated from 1/2002 to 4/2023. Patients were included in the study if they had a minimum of 2 endoscopic evaluations, with index colonoscopy showing Mayo Endoscopic Score (MES) with active disease (≥1) that was limited to the rectum (extent ≤ 20 cm). Endoscopic healing was defined as MES 0 or 1 on follow up endoscopy. Statistical significance was calculated using Chi-square for categorical variables and independent T-test for quantitative variables. Results: Of the 200 patients with isolated proctitis, 25 had a cecal patch present at index colonoscopy. Between those with a cecal patch and those without, there were no significant differences in patient demographics, baseline inflammatory marker values (C-reactive protein and fecal calprotectin), or baseline medication use (steroids, mesalamine, immunomodulator or biologic agents). In univariate analysis, the presence of a cecal patch was not significantly associated with proximal extension of disease (P =0.699). In multivariate analysis adjusting for age, sex, race/ethnicity, and index MES score, cecal patch was not a significant risk factor for proximal extension, the need for medical therapy change or escalation, or disease relapse (Table 1). Conclusion: Patients with ulcerative proctitis had similar rates of proximal extension, medical therapy escalation or disease relapse regardless of the presence of a cecal patch. This suggests that a cecal patch does not confer increased risk of disease progression. Table 1. - Multivariate analysis on role of patient and disease characteristics on disease progression Proximal Extension Medical Therapy Change / Escalation Disease Relapse Independent Variable OR 95% CI P-value OR 95% CI P-value OR 95% CI P-value Age at diagnosis 0.99 0.96-1.01 0.251 1.00 0.97-1.03 0.974 0.99 0.98-1.02 0.733 Sex 1.02 0.51-2.02 0.967 1.18 0.48-2.92 0.719 1.37 0.69-2.73 0.298 Race/Ethnicity (ref=white) Black* 0.90 0.17-4.76 0.905 - - - 5.47 0.60-50.0 0.132 Hispanic* 0.61 0.07-5.57 0.659 - - - 1.03 0.19-5.53 0.977 Asian 1.17 0.33-4.08 0.810 0.43 0.05-3.55 0.435 0.47 0.14-1.67 0.245 Other 2.18 0.44-10.76 0.338 1.63 0.28-9.44 0.585 1.58 0.27-9.27 0.613 Unknown 1.58 0.73-3.45 0.248 0.79 0.27-2.31 0.672 1.89 0.87-4.13 0.108 MES Index Score (ref=1) 2 1.17 0.54-2.51 0.689 1.69 0.59-4.88 0.330 1.66 0.82-3.37 0.162 3 0.87 0.26-2.91 0.823 1.07 0.19-6.20 0.938 1.11 0.36-3.42 0.853 Cecal Patch 0.74 0.27-2.05 0.559 1.77 0.60-5.17 0.299 1.30 0.51-3.29 0.584 *There were no patients of Black race or Hispanic ethnicity who underwent medical therapy escalation in the timeframe of this study. CI, confidence interval; MES, Mayo Endoscopic Score.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».