Department of Medicine, Section of Gastroenterology, Boston Medical Center, Boston, MA 02118, USA.
Dig Dis Sci. 2012 Jun;57(6):1544-53. doi: 10.1007/s10620-012-2050-6. Epub 2012 Feb 7.
For ulcerative colitis (UC) patients undergoing ileal pouch-anal anastomosis (IPAA), postoperative complications include chronic pouchitis and development of Crohn's disease (CD) of the pouch.
The aim of this study was to determine if serologic markers obtained postoperatively are associated with the development of complications in UC patients after IPAA.
A retrospective chart review was conducted of UC patients with IPAA were tested for expression of serologic markers. Complications abstracted from medical records included postoperative fistula, CD of the pouch, chronic pouchitis, and diversion or excision of the pouch.
142 patients were enrolled, 44 of whom developed complications. Positive serologic profiles for ASCA IgG and anti-CBir1 markers were found to be associated with the development of any complication, (P = 0.017 and P = 0.002, respectively). A positive anti-CBir1 test was also found to be associated with CD of the pouch and/or fistula formation (P < 0.001). Similarly, both ASCA IgG and anti-CBir1 titers were significantly associated with postoperative IPAA complications (P = 0.034 and P = 0.001, respectively), and anti-CBir1 titers were associated with CD of the pouch and/or fistula formation (P < 0.001). Complications developed after a median follow-up of 216 months (range 1-264).
ASCA IgG and anti-CBir1 markers were associated with the development of complications after IPAA, specifically fistulae and/or CD of the pouch. The ability to identify patients at high risk for adverse outcomes may allow for early aggressive therapy, which may decrease the rate of pouch failure. A prospective study of patients with preoperative serology is ongoing.
对于接受回肠贮袋肛管吻合术（IPAA）的溃疡性结肠炎（UC）患者，术后并发症包括慢性贮袋炎和贮袋克罗恩病（CD）的发展。
本研究旨在确定 IPAA 后 UC 患者术后获得的血清标志物是否与并发症的发展有关。
对接受 IPAA 的 UC 患者进行了回顾性图表审查，并对其血清标志物进行了检测。从病历中提取的并发症包括术后瘘管、贮袋 CD、慢性贮袋炎、贮袋转流或切除。
共纳入 142 例患者，其中 44 例发生并发症。发现抗酿酒酵母抗体（ASCA）IgG 和抗 CBir1 标志物的阳性血清谱与任何并发症的发展相关（P = 0.017 和 P = 0.002）。抗 CBir1 试验阳性也与贮袋 CD 和/或瘘管形成相关（P < 0.001）。同样，ASCA IgG 和抗 CBir1 滴度均与术后 IPAA 并发症显著相关（P = 0.034 和 P = 0.001），抗 CBir1 滴度与贮袋 CD 和/或瘘管形成相关（P < 0.001）。并发症在中位随访 216 个月（范围 1-264）后发生。
ASCA IgG 和抗 CBir1 标志物与 IPAA 后并发症的发展相关，特别是瘘管和/或贮袋 CD。识别高风险不良结局患者的能力可能允许早期积极治疗，从而降低贮袋失败的发生率。一项对术前血清学患者的前瞻性研究正在进行中。
