Benitez Jose-Manuel, Louis Edouard
Department of Gastroenterology, CHU Liège, and GIGA Research, Liège University, Liège, Belgium.
Dig Dis. 2014;32(4):328-36. doi: 10.1159/000358132. Epub 2014 Jun 23.
While therapeutic strategies able to change the natural history of inflammatory bowel diseases (IBD) are being developed, factors predicting aggressive disease are needed to be able to choose the appropriate therapeutic strategy for the individual patient based on the risk/benefit ratio. The aim of this review is to focus on the tools assisting the clinician in routine practice regarding the prediction of disease evolution.
A literature review was performed, which was mainly based on PubMed search, using the following terms: Crohn's disease, ulcerative colitis, inflammatory bowel disease, genetics, serology, biomarkers, endoscopy, C-reactive protein, faecal calprotectin, disease evolution and complications.
For the prediction of disease evolution, clinical characteristics, particularly disease location and behaviour, are probably currently the most useful. In addition, a series of biomarkers, including genetic, serological and inflammatory markers, as well as characteristics of endoscopic lesions may have an added value.
Simple clinical, biological and endoscopic tools may help the clinician in predicting disease evolution in IBD. However, these tools are still insufficient, and prospective evaluation of new genetic and biological markers are needed.
尽管能够改变炎症性肠病（IBD）自然病程的治疗策略正在不断研发，但仍需要能够预测侵袭性疾病的因素，以便基于风险/效益比为个体患者选择合适的治疗策略。本综述的目的是聚焦于在日常实践中协助临床医生预测疾病进展的工具。
进行了一项文献综述，主要基于PubMed搜索，使用了以下术语：克罗恩病、溃疡性结肠炎、炎症性肠病、遗传学、血清学、生物标志物、内镜检查、C反应蛋白、粪便钙卫蛋白、疾病进展和并发症。
就疾病进展的预测而言，临床特征，尤其是疾病部位和行为，目前可能是最有用的。此外，一系列生物标志物，包括遗传、血清学和炎症标志物，以及内镜病变特征可能具有附加价值。
简单的临床、生物学和内镜工具可能有助于临床医生预测IBD的疾病进展。然而，这些工具仍然不足，需要对新的遗传和生物标志物进行前瞻性评估。
