用于早期识别肛门周围瘘管和脓肿患者克罗恩病风险的预测工具（PREFAB）：对荷兰非学术教学中心前瞻性试点研究的分析。

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Techniques in Coloproctology Pub Date : 2025-10-03 DOI:10.1007/s10151-025-03209-0

L J Munster, E J de Groof, S van Dieren, M W Mundt, W A Bemelman, C J Buskens, J D W van der Bilt

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引用次数: 0

摘要

背景：本研究的目的是确定出现肛周疾病时存在克罗恩病（CD）风险的患者，并前瞻性地确定与CD相关的临床特征（“危险信号”）。方法：前瞻性纳入2022年1月至12月期间所有连续≥16年出现肛周脓肿(PAA)/瘘管（PAF）的患者。粪便calprotectin (FCP)是测量所有的病人,并对患者进行筛查与CD的使用相关的潜在红旗肛周的红旗指数(pRFI)问卷。当FCP≥150 mcg/g时行结肠镜检查。结果：共纳入115例患者（中位年龄38岁；IQR 28-53岁），55例PAA(48%)， 60例PAF（52%）。总共有19例患者FCP水平≥150 mcg/g（中位数为381 mcg/g； IQR为191-1040），并被转介进行结肠镜检查，其中10例诊断为CD（占所有患者的9%；占PAF患者的17%）。结论：在所有PAF患者中，基于fcp的CD筛查，大约六分之一的PAF患者，甚至三分之一的PAF患者

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Prediction tool for early identification of patients at risk of Crohn's disease in perianal fistulas and abscesses (PREFAB): Analysis of a prospective pilot study at a non-academic, teaching centre in the Netherlands.

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Background: The aim of this study was to identify patients at risk of Crohn's disease (CD) when presenting with perianal disease and to prospectively identify clinical characteristics ('red flags') associated with CD.

Methods: All consecutive patients ≥ 16 years presenting with a perianal abscess (PAA)/fistula (PAF) between January and December 2022 were prospectively included. Faecal calprotectin (FCP) was measured in all patients, and patients were screened for potential red flags associated with CD by the use of a perianal red flags index (pRFI)-questionnaire. Colonoscopy was performed when FCP ≥ 150 mcg/g.

Results: Overall, 115 patients were included (median age 38 years; IQR 28-53), 55 with PAA (48%) and 60 with PAF (52%). In total, 19 patients had FCP levels ≥ 150 mcg/g (median 381 mcg/g; IQR 191-1040), and were referred for colonoscopy, of which 10 were diagnosed with CD (9% of all patients; 17% of patients with PAF). Of all patients with PAF < 40 years, 29% were diagnosed with CD (9/31). During a minimal follow-up of 2 years, two colonoscopies were performed in patients with clinical suspicion for CD, demonstrating CD in 1 patient, resulting in a total of 11/115 patients with CD (10%), all presenting with PAF (18% of all patients with PAF). Univariate analysis showed that young age (< 40 years; odds ratio [OR] 4.9; 95% confidence interval [CI] 1.0-23.6), abdominal pains (OR 4.8; 95% CI 1.2-19.1), rectal bleeding (OR 4.3; 95% CI 1.2-15.6), fatigue (OR 3.9; 95% CI 1.1-14.4), multiple external (OR 6.0; 95% CI 1.5-24.6)/internal fistula openings (OR 61.2; 95% CI 9.8-383.4), fissures (OR 4.4; 95% CI 1.1-17.2), and proctitis (OR 22.9; 95% CI 1.9-277.5) increased the likelihood of having CD.

Conclusion: With FCP-based screening for CD, approximately one in six patients with PAF, and even one in three patients with PAF < 40 years were diagnosed with CD. Therefore, FCP measurement is suggested in all patients with PAF, especially when they are < 40 years.

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来源期刊

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

期刊介绍： Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.