The Importance of Recognizing Increased Cecal Inflammation in Health and Avoiding the Misdiagnosis of Nonspecific Colitis
Bibliographic record
Abstract
BACKGROUND: An inherent degree of nonpathological mild inflammation in the cecum has been described informally among pathologists. This low-grade inflammation is often reported as "nonspecific colitis," which can confuse clinicians. Our objective was to characterize and quantify inflammatory changes in the cecum and rectum of healthy adults in a blinded study. METHODS: A total of 85 adults free of gastrointestinal symptoms and history of disease underwent colonoscopy plus cecal and rectal biopsies as part of a case control study. Slides were scored independently by two observers. Histology scores 0 (none) to 3 (severe) were assigned for: epithelial injury, crypt architecture, lamina propria cellularity, subcryptal cellularity, and cryptitis. Slides were scored in a blinded fashion. Biopsy slides of cecum and rectum from fifteen patients with ulcerative colitis were randomly distributed within our sample to limit observer bias. RESULTS: Scores for inflammation were greater in the cecum versus rectum for: epithelial injury (0.45 vs 0.26, P= 0.03), crypt architecture distortion (0.25 vs 0.09, P= 0.03), lamina propria cellularity (1.13 vs 0.34, P < 0.001), and cryptitis (0.40 vs 0.11, P < 0.001). CONCLUSIONS: Increased microscopic inflammation of the cecum is present in healthy individuals, compared to the rectum. Caution should be used when describing "colitis" in cecal biopsies. Clinicians should be cautious in their response to biopsy reports identifying patients as having clinically significant "colitis" that is limited to the cecum.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.044 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".