ORIGINAL RESEARCH article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1582238
This article is part of the Research TopicAdvances Towards Precision Medicine in Pediatric-onset Inflammatory Bowel DiseaseView all 4 articles
Exploration of a nomogram for predicting small bowel mucosal healing in pediatric Crohn's disease
Provisionally accepted
Bingxia Chen*
Huiwen Li
Hongli WangLu RenLiya Xiong
Yang Cheng
Rui LiMeiwan CaoZihuan ZengSitang GongPeiyu Chen*
Lanlan Geng*- Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
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Objectives: According to the updated Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE-II), mucosal healing (MH) is the long-term therapeutic target for Crohn's disease (CD). Capsule endoscopy (CE) is effective in evaluating small bowel mucosal inflammation. This research seeks to construct a simple tool for predicting small bowel MH in pediatric CD to aid clinical decision-making. Methods: Data from the medical records of patients with CD who underwent CE at the Guangzhou Women and Children's Medical Center between November 2017 and July 2022 were retrospectively analyzed. The least absolute shrinkage and selection operator (LASSO) logistic regression algorithm was applied to identify predictive factors for small bowel MH. A nomogram incorporating these factors was constructed to predict the probability of MH in this population. Results: In total, 143 CE examinations performed in 91 pediatric CD patients (median age, 11 years) were included. Based on the Lewis scores, the CD patients were divided into "MH"(42 cases) and "non-MH" groups (101 cases). LASSO regression analysis identified erythrocyte sedimentation rate, albumin levels, aspartate transaminase levels, C-reactive protein levels, platelet count, and lymphocyte percentage as the most significant predictors; and thus, these factors were incorporated into the predictive nomogram model. The area under the receiveroperating characteristic (ROC) curve of the predictive nomogram model was 0.855 (95% confidence interval, 0.783-0.926), suggesting a high discrimination power. Conclusion: A nomogram was constructed to predict small bowel MH in pediatric CD patients. This nomogram model can enable accurate and simple attentive observation of small bowel inflammation in CD patients.
Keywords: Crohn's disease, Capsule Endoscopy, mucosal healing, nomogram, Prediction model
Received: 24 Feb 2025; Accepted: 22 May 2025.
Copyright: © 2025 Chen, Li, Wang, Ren, Xiong, Cheng, Li, Cao, Zeng, Gong, Chen and Geng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Bingxia Chen, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
Peiyu Chen, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
Lanlan Geng, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
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