Background:The comparative outcomes of ulcerative colitis(UC)and Crohn’s disease(CD)in patients with primary sclerosing cholangitis(PSC)are unclear;the aim of our study was to make an objective comparison.Methods:A t...Background:The comparative outcomes of ulcerative colitis(UC)and Crohn’s disease(CD)in patients with primary sclerosing cholangitis(PSC)are unclear;the aim of our study was to make an objective comparison.Methods:A total of 273 patients with PSC and inflammatory bowel disease(223 with UC and 50 with CD)were included.Clinical and demographic variables were obtained.Results:The PSC risk score was similar for both groups.The median follow-up period in patients with PSC-UC was 12 years(range 0–38)and that for PSC-CD was 14 years(range 1–36).The median number of disease flares per year was higher in PSC-UC patients than in the PSC-CD group[1vs.0(ranges 0–20 and 0–9,respectively);P<0.001].More patients with UC developed colon neoplasia than CD(35.9%vs.18%;P=0.009).On proportional hazards analysis for the risk of colectomy,UC patients had a 12%higher risk for colectomy[hazard ratio(HR)=0.88;95%confidence interval(CI)0.51–1.51;P=0.64].Liver transplantation for PSC was associated with decreased risk(HR=0.57;95%CI 0.37–0.89;P=0.013),while colon neoplasia increased the risk(HR=3.83;95%CI 2.63–5.58;P<0.001)for colectomy.On proportional hazards analysis for the risk of colon neoplasia,UC patients had 56%higher risk of developing colon neoplasia than CD(HR=0.44;95%CI 0.16–1.25;P=0.12).Conclusions:PSC patients with CD appear to be associated with a lower risk of colon neoplasia and colectomy than PSC patients with UC.展开更多
文摘Background:The comparative outcomes of ulcerative colitis(UC)and Crohn’s disease(CD)in patients with primary sclerosing cholangitis(PSC)are unclear;the aim of our study was to make an objective comparison.Methods:A total of 273 patients with PSC and inflammatory bowel disease(223 with UC and 50 with CD)were included.Clinical and demographic variables were obtained.Results:The PSC risk score was similar for both groups.The median follow-up period in patients with PSC-UC was 12 years(range 0–38)and that for PSC-CD was 14 years(range 1–36).The median number of disease flares per year was higher in PSC-UC patients than in the PSC-CD group[1vs.0(ranges 0–20 and 0–9,respectively);P<0.001].More patients with UC developed colon neoplasia than CD(35.9%vs.18%;P=0.009).On proportional hazards analysis for the risk of colectomy,UC patients had a 12%higher risk for colectomy[hazard ratio(HR)=0.88;95%confidence interval(CI)0.51–1.51;P=0.64].Liver transplantation for PSC was associated with decreased risk(HR=0.57;95%CI 0.37–0.89;P=0.013),while colon neoplasia increased the risk(HR=3.83;95%CI 2.63–5.58;P<0.001)for colectomy.On proportional hazards analysis for the risk of colon neoplasia,UC patients had 56%higher risk of developing colon neoplasia than CD(HR=0.44;95%CI 0.16–1.25;P=0.12).Conclusions:PSC patients with CD appear to be associated with a lower risk of colon neoplasia and colectomy than PSC patients with UC.
