Gastroenterology report · 2026
Prediction of endoscopic postoperative recurrence in Crohn's disease: a nationwide multicenter real-world cohort from China.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hu Fan, Huang Zicheng, Zhu Liangru, Cao Qian, Guo Hong, Fu Yu, Huang Lingjie, Xiang Lingya, Chao Kang, Wang Chao, Gao Xiang, Chen Minhu
Аннотация
BACKGROUND: Preventing endoscopic postoperative recurrence (ePOR) remains a major challenge in Crohn's disease (CD). This study aimed to identify the clinical and histopathological predictors of CD ePOR.
METHODS: This nationwide, multicenter retrospective cohort study included 389 CD patients from five tertiary Chinese IBD centers, all of whom underwent curative ileocolonic resection between July 2016 and June 2024. The primary endpoint was ePOR at 6-12 months after surgery, defined as a modified Rutgeerts' score of ≥ i2b. Prediction models were developed based on the result of multivariate analysis of clinical and pathological data.
RESULTS: The overall ePOR rate was 24.9%. Multivariate analysis showed that prior exposure to biologics [odds ratio (OR) 2.695, 95% confidence interval (CI) 1.605-4.525, P < 0.001] and baseline serum albumin < 35 g/L (OR 2.095, 95% CI 1.160-3.785, P = 0.014) were independent risk factor for ePOR, while preoperative exclusive enteral nutrition (OR 0.338, 95% CI 0.188-0.610, P < 0.001) and early postoperative prophylactic biologic therapy (OR 0.503, 95% CI 0.304-0.832, P = 0.007) were independently associated with a reduced risk of ePOR. Moderate-to-severe lymphoplasmacytic infiltration in the lamina propria (OR 4.924, 95% CI 2.028-11.957, P < 0.001) and lymphangiectasia (OR 4.916, 95% CI 2.395-10.092, P < 0.001) were identified as the significant histopathological predictors at the surgical margins. A prediction model integrating both clinical and pathological variables [area under the receiver operating characteristic curve (AUROC) 0.829] significantly outperformed the clinical-only model (AUROC 0.715, P = 0.001).
CONCLUSIONS: In the era of biologics and perioperative optimization, the 6-12-month ePOR rate among CD patients was 24.9%. A combined clinical-pathological model showed strong predictive performance.
METHODS: This nationwide, multicenter retrospective cohort study included 389 CD patients from five tertiary Chinese IBD centers, all of whom underwent curative ileocolonic resection between July 2016 and June 2024. The primary endpoint was ePOR at 6-12 months after surgery, defined as a modified Rutgeerts' score of ≥ i2b. Prediction models were developed based on the result of multivariate analysis of clinical and pathological data.
RESULTS: The overall ePOR rate was 24.9%. Multivariate analysis showed that prior exposure to biologics [odds ratio (OR) 2.695, 95% confidence interval (CI) 1.605-4.525, P < 0.001] and baseline serum albumin < 35 g/L (OR 2.095, 95% CI 1.160-3.785, P = 0.014) were independent risk factor for ePOR, while preoperative exclusive enteral nutrition (OR 0.338, 95% CI 0.188-0.610, P < 0.001) and early postoperative prophylactic biologic therapy (OR 0.503, 95% CI 0.304-0.832, P = 0.007) were independently associated with a reduced risk of ePOR. Moderate-to-severe lymphoplasmacytic infiltration in the lamina propria (OR 4.924, 95% CI 2.028-11.957, P < 0.001) and lymphangiectasia (OR 4.916, 95% CI 2.395-10.092, P < 0.001) were identified as the significant histopathological predictors at the surgical margins. A prediction model integrating both clinical and pathological variables [area under the receiver operating characteristic curve (AUROC) 0.829] significantly outperformed the clinical-only model (AUROC 0.715, P = 0.001).
CONCLUSIONS: In the era of biologics and perioperative optimization, the 6-12-month ePOR rate among CD patients was 24.9%. A combined clinical-pathological model showed strong predictive performance.