Results: A total 84(4%) UC patients with IPAA (n = 47) or IRA (n = 37) were detected among 2136 UC patients. Among these 84 UC patients, in a preliminary assessment, clinical outcome was evaluated in 31 patients (16 IPAA,15 IRA) with a median follow up of 72 [12-180] months (mos) and a median time interval from surgery of 63 [1-348] mos. Considering the 16 patients with IPAA (8 M, 9 F) vs. the 15 with IRA (5 M,10 F), the median age at first assessment was 44 [range 30-56] vs. 48 [range 23-82] in patients with IPAA or IRA, respectively (p = 0.2123). The median follow up after surgery was 65 [range 12-132] vs. 79 [range 12-180] mos (p = 0.1955). The median time interval from surgery to first clinical assessment after surgery was 48 [range 1-312] vs. 78 [range 2-348] mos (p = 0.1955). Indication for surgery was refractory UC in 30 patients and endoscopic perforation in 1 pt. During the follow up, the following outcomes after surgery were recorded in patients with IPAA vs. IRA: hospitalised patients (n = 6 vs. n = 6 patients, p = 0.8864); additional intestinal surgery (n = 0 vs. n = 4 patients, p = 0.0269), mortality (n = 0 vs. n = 1 patients,p = 0.2938); occurrence of dys-plasia/cancer of the ileum and/or rectum (n = 0 vs. n = 2 patients, p = 0.1310), number endoscopies after surgery (mean: 4 vs. n = 3.75, p = 0.316348), number visits after surgery (mean: 2.4/year vs. n = 1.7/ year, p = 0.2429), mean stool frequency (n = 8.08 vs. n = 4.36; (p = 0.0005), need of biologics, n = 5 vs. n = 1 (p = 0.0834). Conclusion: In a real-life experience, the need for intestinal surgery was significantly higher in patients with IRA vs. IPAA; the mean daily stool frequency was significantly higher in patients with IPAA vs. IRA.No statistically significant differences were found among the two groups in terms of hospitalisation, mortality, cancer/dysplasia and need for biologics. Background: Faecal calprotectin (FC) and faecal immunochemical tests (FIT) have the disadvantage of requiring faecal samples. It has been reported that prostaglandin E-major urinary metabolite (PGE-MUM) values correlate with Mayo endoscopic scores (MESs) for ulcerative colitis (UC). However, there has been no report that PGE-MUM can determine endoscopic remission under remission phase UC, nor comparative study of PGE-MUM with FC and FIT. Thus, we aimed to examine the association between PGE-MUM values and the colonoscopy (CS) results of patients in the remission phase of UC, and to compare the accuracy of using PGE-MUM vs. that of using FC or FIT values for determining endoscopic remission. Methods: Patients diagnosed with UC who were under clinical remission and had planned to undergo CS from August 2017 to March 2019 were enrolled. FC levels were measured and FITs were performed on the day of CS; PGE-MUM was measured either the day before or after CS. Three physicians independently scored the CS findings (MES, Modified Mayo Endoscopic Score [MMES], and UC endoscopic index of severity [UCEIS]) while blinded from clinical information. We analysed the differences in PGE-MUM values between two groups, which were divided between those that did achieve and those that did not achieve the following scores: (1) MES 0 point, (2) MES 1 point, (3) modified MES 0 point, (4) modified MES ≤1 point, (5) UCEIS 0 point, (6) UCEIS ≤2 points. In addition, the accuracy of PGE-MUM, FC, and FIT with respect to determining the achievement of (1) through (6) were compared by using areas under the receiver operating characteristics curves. Patients with altered UC activity between the day of PGE-MUM measurement and CS, and those who received NSAIDs on the day of PGE-MUM measurement, were excluded from the analysis. Results: Of the 125 enrolled subjects, 30 patients were excluded (urine specimens not submitted, 11; poor stool specimens, 6; NSAIDs users, 10; clearly altered UC activity, 3). The remaining 95 patients (average age 48.2 years, 57 males, and 54 patients with total col-itis type), were eligible for analysis. The median PGE-MUM values (in µg/g·Cr) for groups that did or did not achieve (1) through (6) were as follows: (1) 14.6/17.2, p = 0.106; (2) 14.9/20.5, p = 0.039; (3) 14.5/17.4, p = 0.059; (4) 14.1/21.8, p < 0.001; 5) 14.5/17.4, p = 0.059; (6) 14.7/22.2, p = 0.003. The areas under the receiver operating characteristics curves for PGE-MUM/FC/FIT used for determining the achievement of 1) through 6) were as follows: (1) 0.597/0.664/0.682, (2) 0.692/0.74/0.825, (3) 0.613/0.686/0.692, (4) 0.794/0.82/0.786, (5) 0.613/0.686/0.692 and (6) 0.778/0.824/0.825. Conclusion: PGE-MUM is equally as effective as FC and FIT for determining the achievement of endoscopic remission.
CITATION STYLE
Corr, A., Reza, L., Lung, P., Jenkins, I., Antoniou, A., Latchford, A., … Tozer, P. (2020). P279 Early detection of mucinous adenocarcinoma within fistulating peri-anal Crohn’s disease. Journal of Crohn’s and Colitis, 14(Supplement_1), S290–S291. https://doi.org/10.1093/ecco-jcc/jjz203.408
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