Development and Validation of Web-Based Tool to Predict Lamina Propria Fibrosis in Eosinophilic Esophagitis

被引：16

作者：

Hiremath, Girish ^{[1
]}

Sun, Lili ^{[2
]}

Correa, Hernan ^{[3
]}

Acra, Sari ^{[1
]}

Collins, Margaret H. ^{[4
]}

Bonis, Peter ^{[5
]}

Arva, Nicoleta C. ^{[6
]}

Capocelli, Kelley E. ^{[7
]}

Falk, Gary W. ^{[8
]}

King, Eileen ^{[9
]}

Gonsalves, Nirmala ^{[10
]}

Gupta, Sandeep K. ^{[11
]}

Hirano, Ikuo ^{[10
]}

Mukkada, Vincent A. ^{[12
]}

Martin, Lisa J. ^{[12
]}

Putnam, Philip E. ^{[12
]}

Spergel, Jonathan M. ^{[13
]}

Wechsler, Joshua B. ^{[1
]}

Yang, Guang-Yu ^{[14
]}

Aceves, Seema S. ^{[15
]}

Furuta, Glenn T. ^{[1
]}

Rothenberg, Marc E. ^{[16
]}

Koyama, Tatsuki ^{[2
]}

Dellon, Evan S. ^{[17
]}

机构：

[1] Vanderbilt Univ, Monroe Carell Jr Childrens Hosp Vanderbilt, Div Pediat Gastroenterol Hepatol & Nutr, Med Ctr, Nashville, TN 37232 USA

[2] Vanderbilt Univ, Dept Biostat, Med Ctr, Nashville, TN USA

[3] Vanderbilt Univ, Monroe Carell Jr Childrens Hosp Vanderbilt, Div Pediat Pathol, Med Ctr, Nashville, TN USA

[4] Cincinnati Childrens Hosp, Dept Pathol & Lab Med, Cincinnati, OH USA

[5] Wolters Kluwer Hlth, Waltham, MA USA

[6] Ann & Robert H Laurie Childrens Hosp, Dept Pathol & Lab Med, Chicago, IL USA

[7] Childrens Hosp Colorado, Dept Pathol, Aurora, CO USA

[8] Perelman Ctr Adv Med, Dept Med, Philadelphia, PA USA

[9] Cincinnati Childrens Hosp, Dept Pediat, Div Biostat & Epidemiol, Cincinnati, OH USA

[10] Northwestern Med, Div Gastroenterol & Hepatol, Chicago, IL USA

[11] Indiana Univ Sch Med, Div Pediat Gastroenterol Hepatol & Nutr, Indiana, PA USA

[12] Cincinnati Childrens Hosp, Dept Pediat, Cincinnati, OH USA

[13] Univ Penn, Childrens Hosp Philadelphia, Perelman Sch Med, Div Allergy Immunol, Philadelphia, PA USA

[14] Northwestern Feinberg Sch Med, Div Anat Pathol, Chicago, IL USA

[15] Rady Childrens Hosp, Div Rheumatol Allergy & Immunol, San Diego, CA USA

[16] Cincinnati Childrens Hosp, Div Allergy & Immunol, Cincinnati, OH USA

[17] Univ N Carolina, Div Gastroenterol & Hepatol, Sch Med, Chapel Hill, NC USA

来源：

AMERICAN JOURNAL OF GASTROENTEROLOGY | 2022年 / 117卷 / 02期

基金：

美国国家卫生研究院;

关键词：

DISTENSIBILITY; CHILDREN; DISEASE;

D O I：

10.14309/ajg.0000000000001587

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

INTRODUCTION: Approximately half of esophageal biopsies from patients with eosinophilic esophagitis (EoE) contain inadequate lamina propria, making it impossible to determine the lamina propria fibrosis (LPF). This study aimed to develop and validate a web-based tool to predict LPF in esophageal biopsies with inadequate lamina propria. METHODS: Prospectively collected demographic and clinical data and scores for 7 relevant EoE histology scoring system epithelial features from patients with EoE participating in the Consortium of Eosinophilic Gastrointestinal Disease Researchers observational study were used to build the models. Using the least absolute shrinkage and selection operator method, variables strongly associated with LPF were identified. Logistic regression was used to develop models to predict grade and stage of LPF. The grade model was validated using an independent data set. RESULTS: Of 284 patients in the discovery data set, median age (quartiles) was 16 (8-31) years, 68.7% were male patients, and 93.4% were White. Age of the patient, basal zone hyperplasia, dyskeratotic epithelial cells, and surface epithelial alteration were associated with presence of LPF. The area under the receiver operating characteristic curve for the grade model was 0.84 (95% confidence interval: 0.80-0.89) and for stage model was 0.79 (95% confidence interval: 0.74-0.84). Our grade model had 82% accuracy in predicting the presence of LPF in an external validation data set. DISCUSSION: We developed parsimonious models (grade and stage) to predict presence of LPF in esophageal biopsies with inadequate lamina propria and validated our grade model. Our predictive models can be easily used in the clinical setting to include LPF in clinical decisions and determine its effect on treatment outcomes.

引用

页码：272 / 279

页数：8

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