A107 DISEASE DISTRIBUTION AND CLINICAL FEATURES OF INFLAMMATORY BOWEL DISEASE IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS: A SINGLE-CENTRE RETROSPECTIVE ANALYSIS
Bibliographic record
Abstract
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
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".