Data_Sheet_1_Characterization of Mucosal Lesions in Crohn's Disease Scored With Capsule Endoscopy: A Systematic Review.docx

Background and Aims: There is little agreement on the nomenclature and description of Crohn's disease (CD) lesions that can be found in the small and large bowel using capsule endoscopy (CE). We performed a systematic review to identify mucosal lesions that have been described using CE in CD, in both the small bowel and colon, with the aim to make propositions to homogenize such descriptions.
Methods: A systematic literature search was conducted using Embase, Medline (OvidSP), and Cochrane Central on August 6, 2019. Clinical studies providing nomenclature and descriptions for small bowel and colonic inflammatory lesions using CE in CD were selected for data collection.
Results: In total, 851 articles were included for abstract screening out of which 219 were analyzed for full-text review. Twenty-two articles were selected for data extraction. Seven items, accompanied by clear descriptions, were found for the small bowel: i.e., ulcer, erosion, aphthoid lesion, edema, fissure, cobblestone appearance, and villous atrophy. No studies were found describing inflammatory items using CE in colonic CD.
Conclusions: The most frequently described CD lesions using CE were ulcers and erosions. Subjective interpretation of CE inflammatory findings plays an important role. Based on our findings, a range of suggestions regarding items and descriptions is made that might form the basis of a pan-enteric CE activity index.

背景与研究目的：目前对于采用胶囊内镜（capsule endoscopy, CE）在小肠及大肠中观察到的克罗恩病（Crohn's disease, CD）病变的命名与描述标准尚未达成统一共识。本研究开展系统综述，旨在明确克罗恩病患者经胶囊内镜观察到的小肠及结肠黏膜病变类型，并提出统一此类描述的建议。
方法：本研究于2019年8月6日通过Embase、Medline（OvidSP）及Cochrane Central数据库开展系统文献检索，选取针对克罗恩病患者采用胶囊内镜观察小肠及结肠炎性病变并提供命名与描述的临床研究进行数据收集。
结果：共计纳入851篇文献进行摘要筛选，其中219篇经全文审阅后，最终选取22篇进行数据提取。针对小肠病变共发现7类可明确描述的黏膜表现：溃疡、糜烂、阿弗他样病变、水肿、裂隙、鹅卵石征及绒毛萎缩。尚未见有研究采用胶囊内镜描述结肠克罗恩病的炎性病变表现。
结论：采用胶囊内镜描述的克罗恩病病变中，溃疡与糜烂最为常见。胶囊内镜炎性表现的主观判读具有重要影响。基于本研究结果，我们针对病变类型及描述方式提出一系列建议，有望为构建全肠胶囊内镜活动度指数奠定基础。