A107 DISEASE DISTRIBUTION AND CLINICAL FEATURES OF INFLAMMATORY BOWEL DISEASE IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS: A SINGLE-CENTRE RETROSPECTIVE ANALYSIS
Notice bibliographique
Résumé
Inflammatory bowel disease (IBD) associated with primary sclerosing cholangitis (PSC) has previously been reported to have different clinical characteristics compared to IBD without PSC. The aim of this study was to describe the pattern of intestinal disease distribution and clinical features of PSC-IBD at a Canadian tertiary care centre. A retrospective chart review was conducted on all PSC-IBD patients followed at the PSC clinic at a tertiary care centre in Vancouver, Canada, between January 2010 and June 2018. Data collected and analyzed included demographics, medical history, biochemical and imaging results, operative records, and pathology reports. For patients with PSC-ulcerative colitis (UC), disease severity was graded using the Endoscopic Mayo Score. Distal vs. proximal colonic segments were defined relative to the splenic flexure. 69 PSC-IBD patients were identified, 44 (63.8%) were male. Mean age of IBD diagnosis was 28.6 (SD 14.9) years, and PSC was 37.0 (SD 18.9) years. PSC diagnosis preceded IBD in 3 (4.3%) patients. Median length of follow up was 12 (range 2–49) years. Of the PSC-IBD patients, 52 (75.4%) had UC. Among PSC-UC patients, on initial endoscopic assessment, 87.5% had pancolitis, and 12.5 % had proctitis. Among PSC-UC patients with pancolitis, 28.6% had relative rectal sparing (rectal mucosa was either endoscopically normal, or much less inflamed than sigmoid). Of the PSC-UC patients with pancolitis, 14.3% had more severe inflammation in proximal vs. distal colon, whereas only 3.6% had more severe inflammation in distal colon. The remaining 82.1% had the same degree of inflammation throughout. For all PSC-UC patients, no granulomas were found on histology. All patients with PSC-Crohns disease (CD) had colonic involvement on endoscopic exam at diagnosis. Of the PSC-IBD patients, 16 (23.2%) had colectomy. Excluding those with colectomy, 40 (75.5%) patients were on IBD treatment at the time of data extraction. In this PSC-IBD population, 8 (11.6%) patients had cholangiocarcinoma, 1 (1.4%) had colorectal cancer, and 1 (1.4%) had gallbladder cancer. In this PSC-IBD cohort, pancolits was common, with more severe inflammation in the proximal colon, and frequent rectal sparing. This pattern of disease distribution is in concordance with previous population-based studies performed outside of Canada. While rates of colorectal and gallbladder cancer in this cohort were low, cholangiocarcinoma developed in a substantial fraction of patients. These findings support that IBD with PSC may represent a distinct IBD phenotype. Awareness of these distinctive patterns is important in directing appropriate investigations, surveillance, and treatment for these patients. None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».