A novel location classification system for Crohn's disease based on small bowel involvement:a better predictor of disease progression
Huili Guo1
Jian Tang1
Xiusen Qin2
Minzhi Lin1
Miao Li1
Qingfan Yang1
Zicheng Huang1
Xiang Gao1
Kang Chao1
1.Department of Gastroenterology,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China;Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China2.Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China;Department of General Surgery,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong,P.R.China
摘要：Background:Small bowel involvement is related to poor prognosis in Crohn's disease(CD),which may be a potential marker to strat-ify patients with a high risk of progression.This study aimed to establish a novel location classification system for CD and to develop a predictive model for disease progression.
Methods:Consecutive patients with non-stricturing/non-penetrating CD were retrospectively included in the Sixth Affiliated Hospital,Sun Yat-sen University(Guangzhou,P.R.China)between January 2012 and January 2018.Patients were classified into two groups according to disease location:small bowel involvement group and isolated colon group.The primary outcome was disease progression to stricturing or penetrating phenotypes.Progression-free survival was estimated using Cox proportional hazards regres-sion analysis and Kaplan-Meier method.
Results:A total of 463 patients were analysed,with a median follow-up time of 55.3 months.Patients with small bowel involvement had a higher risk of disease progression than those with isolated colon disease(hazard ratio=1.998,P=0.007),while no differences were found between Montreal location classification and disease progression.Median progression-free survival was higher in the iso-lated colon group than in the small bowel involvement group(84.5 vs 77.3 months,P=0.006).Four independent factors associated with disease progression were identified:small bowel involvement,duration of onset of>1 year,deep mucosal ulcer,and C-reactive protein levels of≥10 mg/L(all P<0.05).The nomogram model based on these factors showed good performance in predicting disease progression,with a C-index of 0.746(95%confidence interval,0.707-0.785).
Conclusions:Classifying CD based on small bowel involvement and isolated colon was superior to the Montreal location classifica-tion for predicting disease progression.
机标关键词：involvementcrohnsmallsystemnovelbasedbetterbowel
论文发表日期：2024-04-30
在线出版日期：2026-07-17（本平台首次上网日期，不代表文献的发表时间）
页数：7( 136-142 )
英文信息