Myenteric plexitis is a risk factor for endoscopic and clinical postoperative recurrence after ileocolonic resection in Crohn's disease

被引:41
|
作者
Decousus, Stephanie [1 ]
Boucher, Anne-Laure [2 ]
Joubert, Juliette [1 ]
Pereira, Bruno [3 ]
Dubois, Anne [4 ]
Goutorbe, Felix [2 ]
Dechelotte, Pierre J. [1 ]
Bommelaer, Gilles [2 ,5 ]
Buisson, Anthony [2 ,5 ]
机构
[1] Univ Hosp Estaing, Dept Pathol, Clermont Ferrand, France
[2] Univ Hosp Estaing, Dept Gastroenterol, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand, France
[3] GM Clermont Ferrand Univ & Med Ctr, DRCI, Biostat Unit, Clermont Ferrand, France
[4] Univ Hosp Estaing, Dept Digest Surg, Clermont Ferrand, France
[5] Univ Auvergne, Microbes Intestine Inflammat & Susceptibil Host, UMR 1071, INSERM,USC INRA 2018, Clermont Ferrand, France
关键词
Crohn's disease; Plexitis; Postoperative recurrence; Risk factors; SURGICAL RECURRENCE; PREDICTIVE FACTOR; PREVENTION; INFLIXIMAB; TRIAL; METAANALYSIS; REOPERATION; ADALIMUMAB; THERAPY;
D O I
10.1016/j.dld.2016.02.023
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: As surgical resection is not curative in Crohn's disease, postoperative recurrence remains a crucial issue. The selection of patients, according to available risk factors, remains disappointing in clinical practice highlighting the need for better criteria, such as histologic features. Aims: To investigate whether submucosal and myenteric plexitis increase the risk of endoscopic, clinical and surgical postoperative recurrence in Crohn's disease. Methods: From the pathology department database, we retrospectively retrieved the data of all the patients who have undergone ileocolonic resection for Crohn's disease. Two pathologists, blinded from clinical data, reviewed all specimens to evaluate the presence of plexitis at the proximal resection margin. Results: Of the 75 included CD patients, 19 (25.3%) had histological involvement of resection margin. Inflammatory cells count for myenteric and submucosal plexus were performed in 56 patients. In multivariate analysis, the myenteric plexitis was a risk factor for endoscopic postoperative recurrence (HR 8.83 CI95% [1.6-48.6], p = 0.012), and the presence of at least one myenteric lymphocyte (HR 4.02 CI95% [1.4-11.2], p = 0.008) was predictive of clinical postoperative recurrence. We observed no histologic predictor for surgical postoperative recurrence. Conclusion: Myenteric plexitis in proximal margins of ileocolonic resection specimens is independently associated with endoscopic and clinical postoperative recurrence in Crohn's disease. (C) 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:753 / 758
页数:6
相关论文
共 50 条
  • [31] Clinical and endoscopic recurrence after surgical resection in patients with Crohn's disease
    Lee, Y. W.
    Lee, K. -M.
    Chung, W. C.
    Paik, C. N.
    Sung, H. J.
    Oh, Y. S.
    Jung, S. H.
    JOURNAL OF CROHNS & COLITIS, 2014, 8 : S292 - S292
  • [32] Clinical and Endoscopic Recurrence after Surgical Resection in Patients with Crohn's Disease
    Lee, Yang Woon
    Lee, Kang Moon
    Chung, Woo Chul
    Paik, Chang Nyol
    Sung, Ilea Jung
    Oh, You Suk
    INTESTINAL RESEARCH, 2014, 12 (02) : 117 - 123
  • [33] Crohn's Disease Activity Index Does Not Correlate with Endoscopic Recurrence One Year After Ileocolonic Resection
    Regueiro, Miguel
    Kip, Kevin E.
    Schraut, Wolfgang
    Baidoo, Leonard
    Sepulveda, Antonia R.
    Pesci, Marilyn
    El-Hachem, Sandra
    Harrison, Janet
    Binion, David
    INFLAMMATORY BOWEL DISEASES, 2011, 17 (01) : 118 - 126
  • [34] The association of cigarette smoking with a high risk of recurrence after ileocolonic resection for ileocecal Crohn’s disease
    Takayuki Yamamoto
    Michael R. B. Keighley
    Surgery Today, 1999, 29 : 579 - 580
  • [35] The association of cigarette smoking with a high risk of recurrence after ileocolonic resection for ileocecal Crohn's disease
    Yamamoto, T
    Keighley, MRB
    SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY, 1999, 29 (06): : 579 - 580
  • [36] Risk factors for anastomotic recurrence after ileocolonic resection for Crohn's disease: The importance of smoking.
    Yamamoto, T
    Bain, IM
    Allan, RN
    Keighley, MRB
    GASTROENTEROLOGY, 1998, 114 (04) : A1118 - A1119
  • [37] Plexitis at Primary Ileocaecal Resection Margins as Predictive Factor for Subsequent Recurrence in Crohn's Disease
    Wang, L. M.
    Koh, C. E.
    Szuts, A.
    Olonso-Goncalves, S.
    Tzivinakis, A.
    Misteli, H.
    Guy, R.
    George, B.
    Mortensen, N. J.
    LABORATORY INVESTIGATION, 2013, 93 : 186A - 187A
  • [38] Histological Image-based Ensemble Model to Identify Myenteric Plexitis and Predict Endoscopic Postoperative Recurrence in Crohn's Disease: A Multicentre, Retrospective Study
    Wang, Yuexin
    He, Qi
    Yao, Danhua
    Huang, Yuhua
    Xia, Wenwen
    Chen, Weilin
    Cui, Zhe
    Li, Yousheng
    JOURNAL OF CROHNS & COLITIS, 2024, 18 (05): : 727 - 737
  • [39] Histologic image-based ensemble model to identify myenteric plexitis and predict endoscopic postoperative recurrence in Crohn's disease: a multicentre, retrospective study
    Li, Y.
    Wang, Y.
    JOURNAL OF CROHNS & COLITIS, 2024, 18 : I521 - I521
  • [40] Positive resection margins in Crohn's disease are a relevant risk factor for postoperative disease recurrence
    Kelm, Matthias
    Benatzky, Clara
    Buck, Viktoria
    Widder, Anna
    Schoettker, Katrin
    Rosenfeldt, Mathias
    Brand, Markus
    Schlegel, Nicolas
    Germer, Christoph-Thomas
    Meining, Alexander
    Nusrat, Asma
    Flemming, Sven
    SCIENTIFIC REPORTS, 2024, 14 (01):