BACKGROUND/AIMS Small bowel capsule endoscopy (SBCE) is used to visualize mucosal inflammatory changes in the small intestine of patients with Crohn's disease (CD). The Lewis score (LS) and Capsule Endoscopy Crohn's Disease Activity Index (CECDAI) are used to evaluate the visualized images. We determined the score disagreement between LS and CECDAI in patients with CD. METHODS We evaluated 184 SBCE procedures in 102 CD patients with small bowel lesions. Patients were classified according to the Montreal classification. LS and CECDAI were calculated, and cases with disagreement between the two scores were identified. We investigated the characteristics of disagreement, and analyzed the relationships with the Crohn's Disease Activity Index (CDAI) and C-reactive protein. RESULTS LS (504 ± 1160) correlated strongly with CECDAI (6 ± 5.4) (Spearman's rank correlation coefficient ρ = 0.81, p < 0.0001). LS values of 135 and 790 were equivalent to CECDAI values of 4.9 and 6.9, respectively. The inflammatory changes by LS were significantly observed in several tertiles in the CECDAI discrepancy group (LS < 135, CECDAI ≥ 4.9) compared with the normal agreement group (LS < 135, CECDAI < 4.9) (p < 0.0001). In both groups, CDAI was also significantly different between Montreal L1 and L3 groups (p = 0.0232, p = 0.0196, respectively). LS inflammation score was 0 in six cases in the LS discrepancy group (LS ≥ 135, CECDAI ≤ 4.9, n = 10); the high LS scores were in patients with high stricture scores. CONCLUSIONS Discrepancies between the LS and CECDAI scores were observed in some patients. Cases with high CECDAI alone exhibited extensive inflammation and high disease activity (clinical symptoms and biomarker levels). CECDAI seems to better reflect active intestinal inflammation than LS.

中文翻译：

---

Lewis评分和胶囊内窥镜对克罗恩病患者克罗恩病活动指数的比较。

背景/目的小肠胶囊内镜检查（SBCE）用于可视化克罗恩病（CD）患者小肠的粘膜炎性变化。Lewis评分（LS）和胶囊内窥镜克罗恩病活动指数（CECDAI）用于评估可视化图像。我们确定了CD患者中LS和CECDAI之间的评分不一致。方法我们评估了102例CD肠小病灶患者的184 SBCE程序。根据蒙特利尔分类对患者进行分类。LS和CECDAI进行了计算，并确定了两个分数之间不一致的病例。我们调查了分歧的特征，并分析了与克罗恩病活动指数（CDAI）和C反应蛋白的关系。结果LS（504±1160）与CECDAI（6±5）密切相关。4）（斯皮尔曼等级相关系数ρ= 0.81，p <0.0001）。LS值为135和790分别等于CECDAI值为4.9和6.9。与正常对照组（LS <135，CECDAI <4.9）相比，CECDAI差异组（LS <135，CECDAI≥4.9）的数个三分位数中，LS的炎症变化显着（p <0.0001）。在两组中，CDAI在蒙特利尔L1和L3组之间也存在显着差异（分别为p = 0.0232，p = 0.0196）。在LS差异组中有6例LS炎症评分为0（LS≥135，CECDAI≤4.9，n = 10）; LS分数高的患者是狭窄分数高的患者。结论在某些患者中观察到LS和CECDAI评分之间存在差异。仅CECDAI高的病例表现出广泛的炎症和高的疾病活动性（临床症状和生物标志物水平）。CECDAI似乎比LS更好地反映了主动性肠道炎症。