S1440 The Cecal Patch in Ulcerative Proctitis – A Harbinger of Disease Progression or Merely an Incidental Finding?
Bibliographic record
Abstract
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.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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".