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Histopathological parameters as predictors for the course of Crohn's disease

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Abstract

Background

Recent classification systems discriminate penetrating Crohn's disease (CD) from stricturing and non-stricturing/non-penetrating CD. As yet, no easily detectable marker is known that can predict the course of CD. Individual, clinical course-specific new treatment schemes would be highly desirable for different potentially divergent pathophysiological pathways (e.g., fistula vs stenosis).

Methods

Intestinal tissue biopsies from 63 CD patients with a disease follow-up of up to 7 years were studied retrospectively. In biopsy specimens, 34 histopathological features present prior to the onset of (a) strictures or (b) fistulas were evaluated and compared with biopsies from patients with non-stricturing/non-penetrating disease.

Results

Five histomorphological parameters demonstrated significant associations to different disease courses when applying univariate analysis. In a multivariate logistic regression model (1) severe lymphocytic infiltration of the lamina propria, (2) presence of crypt atrophy, and (3) absence of lymphocytic infiltration of the epithelium are the best variables to predict an uncomplicated disease course (Nagelkerke R2=0.329; P=0.001). The combination of these parameters has a sensitivity of 67% and a specificity of 83% to predict non-stricturing/non-penetrating disease (positive predictive value=0.75).

Conclusion

Histopathological parameters may help to predict complications of CD prior to their onset. The results of this study have to be confirmed prospectively.

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Acknowledgement

This work was supported by the Bundesministerium für Bildung und Forschung (BMBF) Competence network "Inflammatory Bowel Disease".

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Authors and Affiliations

  1. Department of Pathology, University of Regensburg, 93042, Regensburg, Germany

    Frauke Bataille, Petra Rümmele, Peter Wild & Ferdinand Hofstädter

  2. Department of Internal Medicine I, University of Regensburg, 93042, Regensburg, Germany

    Frank Klebl, Rainer H Straub & Jürgen Schölmerich

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  1. Frauke Bataille
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  2. Frank Klebl
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  3. Petra Rümmele
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  4. Rainer H Straub
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  5. Peter Wild
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  6. Jürgen Schölmerich
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  7. Ferdinand Hofstädter
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Correspondence to Frauke Bataille.

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Bataille, F., Klebl, F., Rümmele, P. et al. Histopathological parameters as predictors for the course of Crohn's disease. Virchows Arch 443, 501–507 (2003). https://doi.org/10.1007/s00428-003-0863-6

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  • DOI: https://doi.org/10.1007/s00428-003-0863-6

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