Analysis of transabdominal bowel ultrasound characteristics of immune checkpoint inhibitor-related colitis and their correlation with endoscopy
10.3760/cma.j.cn101480-20240211-00021
- VernacularTitle:免疫检查点抑制剂相关结肠炎的经腹肠道超声特征及其与内镜相关性分析
- Author:
Qingyang ZHOU
1
;
Li MA
;
Hao TANG
;
Xinyu LIU
;
Yanlin ZENG
;
Bo LU
;
Qingli ZHU
;
Bei TAN
;
Jiaming QIAN
Author Information
1. 中国医学科学院 北京协和医学院 北京协和医院消化内科，北京 100730
- Publication Type:Journal Article
- Keywords:
Immune checkpoint inhibitor-related colitis;
Immune checkpoint inhibitor;
Transabdominal bowel ultrasound;
Limberg grade;
Colonoscopy;
Ulcerative colitis e
- From:
Chinese Journal of Inflammatory Bowel Diseases
2025;09(1):67-73
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the characteristics of transabdominal bowel ultrasound (TBUS) in immune checkpoint inhibitor-related colitis (IRC) and their correlation with endoscopic manifestations.Methods:A cross-sectional study was conducted. Clinical data from 10 patients with IRC treated at Peking Union Medical College Hospital from January 2022 to January 2024 were collected. The ulcerative colitis endoscopic index of severity (UCEIS) and Limberg classification were used to assess the severity of colonoscopy and TBUS examinations, respectively. Kendall's tau-b method was applied for correlation analysis between UCEIS scores and Limberg classification.Results:All the 10 patients were male with a median age of 65 years (59-74 years). The majority had lung cancer (8 patients) and all were in advanced stages, with 6 patients in stage Ⅲ and 4 in stage Ⅳ. They all received anti-programmed death 1 (PD-1) /anti-programmed death ligand 1 (PD-L1) combined with chemotherapy, among whom 2 patients were combined with anti-angiogenic drug treatment. The median time from the first immunotherapy to the onset of IRC was 1.50 (0.25-12.00) months; the median time from IRC treatment to clinical symptom relief to G1 was 2.45 (0.50-8.00) weeks. Nine patients were in the active phase, mainly G3 (8 patients) ; 1 was in the remission phase after treatment. TBUS showed that among the 9 active IRC patients, the entire colon was mainly involved (7 patients), with combined small intestine involvement (3 patients) ; the main manifestations were thickening of the bowel wall, with the thickest bowel wall being 7.0 (5.0-8.0) mm, mainly located in the sigmoid colon (3 patients) and descending colon (3 patients) ; increased bowel wall blood flow signals (Limberg classification 2-4) occurred in 7 patients; 3 active patients had perienteric fat wrapping, and 2 had blurred bowel wall stratification. The Kendall's tau-b correlation coefficient r between the entire colon UCEIS scores and Limberg classification was 0.891 ( P = 0.003), and the Kendall's tau-b correlation coefficient r between the colon segment UCEIS scores and Limberg classification was 0.690 ( P < 0.001) . Conclusion:During the active phase, the left colon of IRC is more severe in TBUS, which mainly manifests as the thickening bowel wall and increased blood flow signals, and the TBUS has good correlation with colonoscopy evaluation.
