Janczewska I, Kapraali M, Saboonchi F, Nekzada Q, Wessulv Å, Khoshkar J, Marouf F, Gorsetman J, Risberg D, Lissing M, Wirström G, Sandstedt B
Department of Clinical Sciences, Karolinska Institutet, Division of Internal Medicine Danderyd Hospital, Stockholm, Sweden.
Scand J Gastroenterol. 2012 Feb;47(2):162-9. doi: 10.3109/00365521.2011.647065. Epub 2012 Jan 10.
The newly described--multigene analysis test (DiBiCol) identifying 7 inflammatory bowel disease (IBD)-specific genes in colonic mucosal biopsy differentiating between ulcerative colitis (UC) and Crohn's disease (CD) with active inflammation--is a new addition to existing methods with a higher stated sensitivity and specificity. Method biopsy material from 78 patients with a complicated course diagnosed as most probably UC in 38, CD in 18 and inflammatory bowel disease unclassified (IBDU) in 22 were investigated by DiBiCol.
DiBiCol showed a pattern consistent with CD in 13 patients with UC and led to change of diagnosis in 3 patients and a strong suggestion of CD in 8 patients. A total of 2 patients remained as UC. DiBiCol showed a pattern of UC in 4 patients of 18 with CD leading to a changing of diagnosis to UC in 3 patients, but the fourth remained as CD. In 22 patients with IBDU DiBiCol showed a pattern consistent with UC in 7 cases and with CD in 13 cases. A new evaluation 1 year after the DiBiCol allowed the assessment of clinical diagnosis in 10 patients confirmed in 9 of 10 patients by DiBiCol. In patients with acute flare of colitis the clinical diagnosis corresponded in 10 of 12 UC and in 5 of 6 CD cases.
Adopting the DiBiCol test led to a change of the primary diagnosis in a significant number of patients with the initial diagnosis of UC and CD and suggested a clinically probable diagnosis in most of the patients with IBDU and in those with an acute flare of colitis.
新描述的多基因分析检测（DiBiCol）可在结肠黏膜活检中识别7个炎症性肠病（IBD）特异性基因，以区分活动期炎症的溃疡性结肠炎（UC）和克罗恩病（CD），这是现有方法中的一项新检测，其灵敏度和特异性更高。对78例病程复杂的患者进行了研究，其中38例最可能诊断为UC，18例为CD，22例为未分类的炎症性肠病（IBDU），采用DiBiCol检测其活检材料。
DiBiCol检测显示，13例UC患者呈现出与CD一致的模式，导致3例患者诊断改变，8例患者强烈提示为CD。共有2例患者仍诊断为UC。DiBiCol检测显示，18例CD患者中有4例呈现出UC模式，导致3例患者诊断改为UC，但第4例仍诊断为CD。在22例IBDU患者中，DiBiCol检测显示7例呈现出与UC一致的模式，13例呈现出与CD一致的模式。DiBiCol检测1年后的重新评估使得对10例患者的临床诊断得以评估，DiBiCol在10例患者中的9例得到了确认。在结肠炎急性发作的患者中，12例UC患者中有10例、6例CD患者中有5例临床诊断与之相符。
采用DiBiCol检测导致相当数量初诊为UC和CD的患者的初步诊断发生改变，并在大多数IBDU患者和结肠炎急性发作患者中提示了临床上可能的诊断。
