Abstract
Background: Capsule endoscopy can be used to identify the early stage of small bowel Crohn’s disease (CD). We evaluated significant small bowel capsule endoscopy (SBCE) findings that can lead to early diagnosis of CD. Methods: We retrospectively accumulated clinical and SBCE data of 108 patients (63 with and 45 without CD). Types of small bowel mucosal injuries, including erosion, ulceration, and cobblestone appearance, and the alignment of diminutive lesions were compared between patients with and without CD. Inter- and intra-observer agreement in the determination of lesions was assessed in 25 pairs of SBCE from the two groups. Results: Under SBCE, cobblestone appearance (33% vs. 2%, p < 0.0001), longitudinal ulcers (78% vs. 20%, p < 0.0001), and irregular ulcers (84% vs. 60%, p < 0.01) were more frequently found in patients with CD. Linear erosion (90% vs. 38%, p < 0.0001) and irregular erosion (89% vs. 64%, p < 0.005) were also more frequent in patients with CD. Furthermore, circumferential (75% vs. 9%, p < 0.0001) and longitudinal (56% vs. 7%, p < 0.0001) alignment of diminutive lesions, mainly observed in the 1st tertile of the small bowel, was more frequent in patients with CD. Good intra-observer agreement was found for ulcers, cobblestone appearance, and lesion alignment. However, inter-observer agreement of SBCE findings differed among observers. Conclusions: Circumferential or longitudinal alignment of diminutive lesions, especially in the upper small bowel, may be a diagnostic clue for CD under SBCE, while inter-observer variations should be cautiously considered when using SBCE.
Original language | English |
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Pages (from-to) | 249-260 |
Number of pages | 12 |
Journal | Journal of gastroenterology |
Volume | 54 |
Issue number | 3 |
DOIs | |
Publication status | Published - Mar 15 2019 |
All Science Journal Classification (ASJC) codes
- Gastroenterology
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Capsule endoscopy findings for the diagnosis of Crohn’s disease : a nationwide case–control study. / Esaki, Motohiro; Matsumoto, Takayuki; Ohmiya, Naoki; Washio, Ema; Morishita, Toshifumi; Sakamoto, Kei; Abe, Hiroo; Yamamoto, Shojiro; Kinjo, Tetsu; Togashi, Kazutomo; Watanabe, Kenji; Hirai, Fumihito; Nakamura, Masanao; Nouda, Sadaharu; Ashizuka, Shinya; Omori, Teppei; Kochi, Shuji; Yanai, Shunichi; Fuyuno, Yuta; Hirano, Atsushi; Umeno, Junji; Kitazono, Takanari; Kinjo, Fukunori; Watanabe, Mamoru; Matsui, Toshiyuki; Suzuki, Yasuo.
In: Journal of gastroenterology, Vol. 54, No. 3, 15.03.2019, p. 249-260.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Capsule endoscopy findings for the diagnosis of Crohn’s disease
T2 - a nationwide case–control study
AU - Esaki, Motohiro
AU - Matsumoto, Takayuki
AU - Ohmiya, Naoki
AU - Washio, Ema
AU - Morishita, Toshifumi
AU - Sakamoto, Kei
AU - Abe, Hiroo
AU - Yamamoto, Shojiro
AU - Kinjo, Tetsu
AU - Togashi, Kazutomo
AU - Watanabe, Kenji
AU - Hirai, Fumihito
AU - Nakamura, Masanao
AU - Nouda, Sadaharu
AU - Ashizuka, Shinya
AU - Omori, Teppei
AU - Kochi, Shuji
AU - Yanai, Shunichi
AU - Fuyuno, Yuta
AU - Hirano, Atsushi
AU - Umeno, Junji
AU - Kitazono, Takanari
AU - Kinjo, Fukunori
AU - Watanabe, Mamoru
AU - Matsui, Toshiyuki
AU - Suzuki, Yasuo
N1 - Funding Information: Funding This work was supported in part by Health and Labour Sciences Grants for research on intractable diseases from Ministry of Health, Labour and Welfare of Japan (Investigation and Research for Intractable Inflammatory Bowel Disease). The funder of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. Funding Information: Conflict of interest Motohiro Esaki received research grants from, Mitsubishi Tanabe Pharma Corporation, EA Pharma Co., Ltd., Abb-Vie GK, ZERIA Pharmaceutical Co., Ltd., and Asahi Kasei Medical Co., Ltd., and lecture fee from Mitsubishi Tanabe Pharma Corporation and AbbVie GK, outside the submitted work. Takayuki Mat-sumoto received research grants from Mitsubishi Tanabe Pharma Corporation, EA Pharma Co., Ltd., and Nippon Kayaku Co., Ltd., and lecture fee from Mitsubishi Tanabe Pharma Corporation, EA Pharma Co., Ltd., KYORIN Pharmaceutical Co., Ltd., AbbVie GK, Janssen Pharmaceutical K.K., Mochida Pharmaceutical Co., Ltd., Pfizer Inc., Zeria Pharmaceutical Co., Ltd., and AstraZeneca plc, and advisory fee from JIMRO Co., Ltd., Kissei Pharmaceutical Co., Ltd., and Takeda Pharmaceutical Co., Ltd., outside the submitted work. Naoki Ohmiya received research grants from Otsuka Pharamaceutical Factory, Inc., JIMRO Co., Ltd., Mochida Pharmaceutical Co., Ltd., Daiichi Sankyo Company, Limited, Astellas Pharma Inc., Eli Lilly and Company, Mitsubishi Tanabe Pharma Corporation, EA Pharma Co., Ltd., TAIHO Pharmaceutical Co. Ltd., Takeda Pharmaceutical Co., Ltd., Tsumura & Co., KYORIN Pharmaceutical Co., Ltd., and Asahi kasei Pharma, and lecture fee from KYORIN Pharmaceutical Co., Ltd., Fujifilm medical Co., Covidien Japan, EA Pharma Co. Ltd., KYORIN Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceutical Co., Ltd., ZERIA Pharmaceutical Co., Ltd., Astellas Pharma Inc., AbbVie GK, and Mylan Inc, outside the submitted work. Kenji Watanabe received research grants from AbbVie GK, Mitsubishi Tanabe Pharma Corporation, EA Pharma Co., Ltd., Asahi Kasei Medical Co., Ltd., Kyowa Hakko Kirin Co., Ltd, Kyorin Pharmaceutical Co., Ltd, Astellas Pharma Inc, and JIMRO Co., Ltd., and consulting fee from EA Pharma Co., Ltd., Mitsubishi Tanabe Pharma Corporation, AbbVie GK, Kyorin Pharmaceutical Co., Ltd., Asahi Kasei Medical Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Takeda Pharmaceutical Co., Ltd., JIMRO Co., Ltd., Olympus Corporation, Covidien Japan Co., Ltd., Mochida Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., Pfizer Japan Inc., and Otsuka Pharmaceutical Co., Ltd., and lecture fee from Mitsubishi Tanabe Pharma Corporation, Eisai Co., Ltd, AbbVie GK, Asahi Kasei Medical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Kyorin Pharmaceutical Co., Ltd., Astellas Pharma Inc., JIMRO Co., Ltd., UCB Japan Co., Ltd., Zeria Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Olympus Corporation, Covidien Japan Co., Ltd., and Otsuka Pharmaceutical Co., Ltd., and advisory fee from Takeda Pharmaceutical Co., Ltd., Mochida Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., Pfizer Japan Inc., EA Pharma Co., Ltd., Mitsubishi Tanabe Pharma Corporation, and JIMRO Co., Ltd., outside the submitted work. Fumihito Hirai received research grants from AbbVie GK, Mitsubishi Tanabe Pharma Corporation, EA Pharma Co., Ltd., JIMRO Co., Ltd., ZERIA Pharmaceutical Co., Ltd., and Eisai Co., Ltd., and lecture fee from AbbVie GK, EA Pharma Co., Ltd., Eisai Co., Ltd. And Mit-subishi Tanabe Pharma Corporation, outside the submitted work. Atsushi Hirano received research grants from AbbVie GK, and Mit-subishi Tanabe Pharma Corporation, outside the submitted work. Takanari Kitazono received research grants from Daiichi Sankyo Co., Funding Information: Ltd., Takeda Pharmaceutical Co. Ltd., MSD Co., Ltd. Nippon Boehringer Ingelheim Co., Ltd., Sanofi-Aventis Co., Ltd. Pfizer Inc., Bayer yakuhin, Ltd., and Eisai Co., Ltd., and lecture fee from Daiichi Sankyo Co., Ltd., Bayer yakuhin, Ltd., and Chugai Pharmaceutical Co., Ltd., outside the submitted work. Mamoru Watanabe received research grants from Asahi Kasei Medical Co., Ltd., Ajinomoto Co., Inc., AbbVie GK, EA Pharma Co., Ltd., Eisai Co., Ltd., Kyorin Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corp., Otsuka Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co. Ltd., Zeria Pharmaceutical Co., Ltd., JIMRO Co., Ltd., Takeda Pharmaceutical Co., Ltd., Nippon Kayaku Co., Ltd., Mochida Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Ono Pharmaceutical Co., Ltd., Astellas Pharma Inc., MSD K.K., Dainippon Sumitomo Dainippon Pharma Co., Ltd., Bristol-Myers, K.K, and Chugai Pharmaceutical Co., Ltd., and lecture fees from Mitsubishi Tanabe Pharma Corp., Eisai Co., Ltd., Kyorin Pharmaceutical Co., Ltd., JIMRO Co., Ltd., Ajinomoto Co., Inc., AbbVie GK, Takeda Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co. Ltd., Zeria Pharmaceutical Co., Ltd., Asahi Kasei Medical Co., Ltd., EA Pharma Co., Ltd., Astellas Pharma Inc., Mochida Pharmaceutical Co., Ltd., Janssen Pharmaceutical Co., Ltd., Gilead Sciences, Inc., Celgene Corp., outside the submitted work. Toshiyuki Matsui received research grants from AbbVie GK, Mit-subishi Tanabe Pharma Corporation, EA Pharma Co., Ltd., JIMRO Co., Ltd., ZERIA Pharmaceutical Co., Ltd., Eisai Co., Ltd., Astellas Pharma Inc, and Takeda Pharmaceutical Co. Ltd., and lecture fee from AbbVie GK, and EA Pharma Co., outside the submitted work. Yasuo Suzuki received research grants from AbbVie GK, Mitsubishi Tanabe Pharma Corporation, Ltd., EA Pharma Co., Ltd., JIMRO Co., Ltd., Mochida Pharmaceutical Co., Ltd., and Nippon Kayaku Co., Ltd., and lecture fee from Mitsubishi Tanabe Pharma Corporation, AbbVie GK, EA Pharma Co. Ltd., ZERIA Pharmaceutical Co., Ltd., Mochida Pharmaceutical Co., Ltd., and KYORIN Pharmaceutical Co., Ltd., outside the submitted work. All other authors have no competing interests to declare. Publisher Copyright: © 2018, The Author(s). Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/3/15
Y1 - 2019/3/15
N2 - Background: Capsule endoscopy can be used to identify the early stage of small bowel Crohn’s disease (CD). We evaluated significant small bowel capsule endoscopy (SBCE) findings that can lead to early diagnosis of CD. Methods: We retrospectively accumulated clinical and SBCE data of 108 patients (63 with and 45 without CD). Types of small bowel mucosal injuries, including erosion, ulceration, and cobblestone appearance, and the alignment of diminutive lesions were compared between patients with and without CD. Inter- and intra-observer agreement in the determination of lesions was assessed in 25 pairs of SBCE from the two groups. Results: Under SBCE, cobblestone appearance (33% vs. 2%, p < 0.0001), longitudinal ulcers (78% vs. 20%, p < 0.0001), and irregular ulcers (84% vs. 60%, p < 0.01) were more frequently found in patients with CD. Linear erosion (90% vs. 38%, p < 0.0001) and irregular erosion (89% vs. 64%, p < 0.005) were also more frequent in patients with CD. Furthermore, circumferential (75% vs. 9%, p < 0.0001) and longitudinal (56% vs. 7%, p < 0.0001) alignment of diminutive lesions, mainly observed in the 1st tertile of the small bowel, was more frequent in patients with CD. Good intra-observer agreement was found for ulcers, cobblestone appearance, and lesion alignment. However, inter-observer agreement of SBCE findings differed among observers. Conclusions: Circumferential or longitudinal alignment of diminutive lesions, especially in the upper small bowel, may be a diagnostic clue for CD under SBCE, while inter-observer variations should be cautiously considered when using SBCE.
AB - Background: Capsule endoscopy can be used to identify the early stage of small bowel Crohn’s disease (CD). We evaluated significant small bowel capsule endoscopy (SBCE) findings that can lead to early diagnosis of CD. Methods: We retrospectively accumulated clinical and SBCE data of 108 patients (63 with and 45 without CD). Types of small bowel mucosal injuries, including erosion, ulceration, and cobblestone appearance, and the alignment of diminutive lesions were compared between patients with and without CD. Inter- and intra-observer agreement in the determination of lesions was assessed in 25 pairs of SBCE from the two groups. Results: Under SBCE, cobblestone appearance (33% vs. 2%, p < 0.0001), longitudinal ulcers (78% vs. 20%, p < 0.0001), and irregular ulcers (84% vs. 60%, p < 0.01) were more frequently found in patients with CD. Linear erosion (90% vs. 38%, p < 0.0001) and irregular erosion (89% vs. 64%, p < 0.005) were also more frequent in patients with CD. Furthermore, circumferential (75% vs. 9%, p < 0.0001) and longitudinal (56% vs. 7%, p < 0.0001) alignment of diminutive lesions, mainly observed in the 1st tertile of the small bowel, was more frequent in patients with CD. Good intra-observer agreement was found for ulcers, cobblestone appearance, and lesion alignment. However, inter-observer agreement of SBCE findings differed among observers. Conclusions: Circumferential or longitudinal alignment of diminutive lesions, especially in the upper small bowel, may be a diagnostic clue for CD under SBCE, while inter-observer variations should be cautiously considered when using SBCE.
UR - http://www.scopus.com/inward/record.url?scp=85053461236&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85053461236&partnerID=8YFLogxK
U2 - 10.1007/s00535-018-1507-6
DO - 10.1007/s00535-018-1507-6
M3 - Article
C2 - 30219994
AN - SCOPUS:85053461236
VL - 54
SP - 249
EP - 260
JO - Journal of Gastroenterology
JF - Journal of Gastroenterology
SN - 0944-1174
IS - 3
ER -