P644 Leucine-rich alpha 2 glycoprotein- A useful biomarker to discriminate small intestinal mucosal healing in asymptomatic CRP-negative Crohn’s disease
Bibliographic record
Abstract
Abstract Background The long-term treatment goals for inflammatory bowel disease including Crohn’s disease (CD) have shifted from clinical remission to mucosal healing. However, frequent endoscopies are a great burden on the patients. Leucine-rich alpha 2 glycoprotein (LRG) is produced by hepatocytes, neutrophils, and the intestinal epithelium. Therefore, it is speculated to be more gut-specific than C-reactive protein (CRP) level. This study examined whether LRG could be used as a biomarker to determine the presence or absence of small intestinal mucosal healing in asymptomatic patients with CRP-negative CD. Methods The subjects of this study were asymptomatic CRP-negative CD patients who visited our department from May 2021 to October 2022, had their LRG measured, and underwent imaging evaluation by capsule endoscopy or balloon-assisted endoscopy. We analysed the patients’ clinical background, the ROC-AUC of LRG for mucosal healing, the cut-off value of LRG to discriminate mucosal healing. Endoscopic evaluation was performed within 3 months before and after the LRG measurement. Mucosal healing was defined as the absence of open ulcers. Clinical remission (no subjective symptoms) was defined as a Harvey-Bradshaw index (HBI) ≤4 points. The upper limit of the normal CRP value was set to <3 mg/L. Results A total of 28 cases were analysed; 13 (46%) were men. The median age (range) of onset was 21.2 years (7-52 years). The median disease duration (range) was 6.4 years (0-27). B1 was established in 13 (45%) cases, B2 in 7 (25%) cases and B3 of Montreal Classification in 8 (29%) cases. The median (range) of the HBI score was 2 (0-4). The median (range) of LRG was 12.3 g/ml (7.6-20.5 μg/ml). The ROC-AUC of LRG for mucosal healing was 0.743 (95% confidence interval 0.559-0.927). The cut-off value of LRG for discriminating mucosal healing was 12.2 μg/ml (sensitivity 0.769, specificity 0.682). Conclusion In asymptomatic CRP-negative CD patients, when LRG was 12.2 μg/ml or more, it was suggested that they might have small intestinal ulcers.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".