Leucine-rich alpha-2 glycoprotein reflects transmural inflammation assessed by through-the-scope endoscopic ultrasonography: A prospective study in small-bowel Crohn’s disease

Figure 1 Flowchart of patient selection. CD: Crohn’s disease; DBE-EUS: Endoscopic ultrasonography during double-balloon enteroscopy; LRG: Leucine-rich alpha-2 glycoprotein.

Figure 2 Serum leucine-rich alpha-2 glycoprotein levels in patients with transmural healing and transmural inflammation. A: In the overall cohort; B: Among patients in clinical remission. TWT: Total wall thickness; SMT: Submucosal thickness.

Figure 3 Receiver operating characteristic curves for assessing transmural inflammation in the overall cohort and clinical remission. A-D: In the overall cohort: Biomarkers for total wall thickness (TWT) ≥ 2.65 mm (A); Biomarkers for submucosal thickness (SMT) ≥ 0.95 mm (B); Disease activity indices for TWT ≥ 2.65 mm (C); Disease activity indices for SMT ≥ 0.95 mm (D); E and F: In clinical remission: Biomarkers for TWT ≥ 2.65 mm (E); Biomarkers for SMT ≥ 0.95 mm (F). TWT: Total wall thickness; SMT: Submucosal thickness; CRP: C-reactive protein; LRG: Leucine-rich alpha-2 glycoprotein; FC: Fecal calprotectin; AUC: Area under the curve; CDAI: Crohn’s disease activity index; SES-CD: Simple endoscopic score for Crohn’s disease.

Figure 4 Correlation analysis between serum leucine-rich alpha-2 glycoprotein levels and endoscopic ultrasonography during double-balloon enteroscopy parameters. A: In the overall cohort; B: Among patients in clinical remission. LRG: Leucine-rich alpha-2 glycoprotein; TWT: Total wall thickness; SMT: Submucosal thickness; MT: Mucosal thickness; MPT: Muscularis propria thickness.

Figure 5 Kaplan-Meier analysis. A-D: Crohn’s disease-related hospitalization-free survival in the overall cohort stratified by total wall thickness (TWT) ≥ 2.65 mm (A), leucine-rich alpha-2 glycoprotein (LRG) ≥ 14.68 μg/mL (B), submucosal thickness (SMT) ≥ 0.95 mm (C), LRG ≥ 15.80 μg/mL (D); E-H: Relapse-free survival among patients in clinical remission stratified by TWT ≥ 2.65 mm (E), LRG ≥ 13.99 μg/mL (F), SMT ≥ 0.95 mm (G), LRG ≥ 15.72 μg/mL (H). LRG: Leucine-rich alpha-2 glycoprotein; TWT: Total wall thickness; SMT: Submucosal thickness.