Published in:
Open Access
01-12-2019 | Crohn's Disease | Research article
A novel collagen area fraction index to quantitatively assess bowel fibrosis in patients with Crohn’s disease
Authors:
Xue-hua Li, Zhuang-nian Fang, Tian-ming Guan, Jin-jiang Lin, Can-hui Sun, Si-yun Huang, Ren Mao, Bao-lan Lu, Qing-hua Cao, Shi-ting Feng, Zi-ping Li
Published in:
BMC Gastroenterology
|
Issue 1/2019
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Abstract
Background
A validated histopathological tool to precisely evaluate bowel fibrosis in patients with Crohn’s disease is lacking. We attempted to establish a new index to quantify the severity of bowel fibrosis in patients with Crohn’s disease-associated fibrostenosis.
Methods
We analyzed the histopathological data of 31 patients with Crohn’s disease strictures undergoing surgical resection. The most representative sections of resected strictured segments were stained with Masson trichrome to manifest bowel fibrosis. The collagen area fraction and histological fibrosis score were simultaneously calculated for the same section to evaluate the severity of bowel fibrosis.
Results
Collagen area fraction strongly correlated with histological fibrosis scores (r = 0.733, P < 0.001). It showed a stronger correlation (r = 0.561, P < 0.001) with the degree of bowel strictures than the histological fibrosis score did (r = 0.468, P < 0.001). It was also shown to be more accurate for diagnosing Crohn’s disease strictures (area under the receiver operating characteristic curve = 0.815, P < 0.001) compared with the histological fibrosis score (area under the curve = 0.771, P < 0.001). High repeatability was observed for the collagen area fraction, with an intraclass correlation coefficient of 0.915 (P < 0.001).
Conclusions
Collagen area fraction is a simple and reliable index to quantify the severity of bowel fibrosis in patients with Crohn’s disease-associated fibrostenosis.