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Article: Changes in Crohn's disease phenotype over time in the Chinese population: Validation of the Montreal classification system

TitleChanges in Crohn's disease phenotype over time in the Chinese population: Validation of the Montreal classification system
Authors
Issue Date2008
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.ibdjournal.com
Citation
Inflammatory Bowel Diseases, 2008, v. 14 n. 4, p. 536-541 How to Cite?
Abstract
Background: Phenotypic evolution of Crohn's disease occurs in whites but has never been described in other populations. The Montreal classification may describe phenotypes more precisely. The aim of this study was to validate the Montreal classification through a longitudinal sensitivity analysis in detecting phenotypic variation compared to the Vienna classification. Methods: This was a retrospective longitudinal study of consecutive Chinese Crohn's disease patients. All cases were classified by the Montreal classification and the Vienna classification for behavior and location. The evolution of these characteristics and the need for surgery were evaluated. Results: A total of 109 patients were recruited (median follow-up: 4 years, range: 6 months-18 years). Crohn's disease behavior changed 3 years after diagnosis (P = 0.025), with an increase in stricturing and penetrating phenotypes, as determined by the Montreal classification, but was only detected by the Vienna classification after 5 years (P = 0.015). Disease location remained stable on follow-up in both classifications. Thirty-four patients (31%) underwent major surgery during the follow-up period with the stricturing [P = 0.002; hazard ratio (HR): 3.3; 95% CI: 1.5-7.0] and penetrating (P = 0.03; HR: 5.8; 95% CI: 1.2-28.2) phenotypes according to the Montreal classification associated with the need for major surgery. In contrast, colonic disease was protective against a major operation (P = 0.02; HR: 0.3; 95% CI: 0.08-0.8). Conclusions: This is the first study demonstrating phenotypic evolution of Crohn's disease in a nonwhite population. The Montreal classification is more sensitive to behavior phenotypic changes than is the Vienna classification after excluding perianal disease from the penetrating disease category and was useful in predicting course and the need for surgery. Copyright © 2007 Crohn's & Colitis Foundation of America, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/163162
ISSN
2013 Impact Factor: 5.475
ISI Accession Number ID
References

 

Author Affiliations
  1. Prince of Wales Hospital Hong Kong
  2. University of New South Wales
DC FieldValueLanguage
dc.contributor.authorChow, DKLen_US
dc.contributor.authorLeong, RWLen_US
dc.contributor.authorLai, LHen_US
dc.contributor.authorWong, GLHen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorChan, FKLen_US
dc.contributor.authorSung, JJYen_US
dc.date.accessioned2012-09-05T05:28:21Z-
dc.date.available2012-09-05T05:28:21Z-
dc.date.issued2008en_US
dc.identifier.citationInflammatory Bowel Diseases, 2008, v. 14 n. 4, p. 536-541en_US
dc.identifier.issn1078-0998en_US
dc.identifier.urihttp://hdl.handle.net/10722/163162-
dc.description.abstractBackground: Phenotypic evolution of Crohn's disease occurs in whites but has never been described in other populations. The Montreal classification may describe phenotypes more precisely. The aim of this study was to validate the Montreal classification through a longitudinal sensitivity analysis in detecting phenotypic variation compared to the Vienna classification. Methods: This was a retrospective longitudinal study of consecutive Chinese Crohn's disease patients. All cases were classified by the Montreal classification and the Vienna classification for behavior and location. The evolution of these characteristics and the need for surgery were evaluated. Results: A total of 109 patients were recruited (median follow-up: 4 years, range: 6 months-18 years). Crohn's disease behavior changed 3 years after diagnosis (P = 0.025), with an increase in stricturing and penetrating phenotypes, as determined by the Montreal classification, but was only detected by the Vienna classification after 5 years (P = 0.015). Disease location remained stable on follow-up in both classifications. Thirty-four patients (31%) underwent major surgery during the follow-up period with the stricturing [P = 0.002; hazard ratio (HR): 3.3; 95% CI: 1.5-7.0] and penetrating (P = 0.03; HR: 5.8; 95% CI: 1.2-28.2) phenotypes according to the Montreal classification associated with the need for major surgery. In contrast, colonic disease was protective against a major operation (P = 0.02; HR: 0.3; 95% CI: 0.08-0.8). Conclusions: This is the first study demonstrating phenotypic evolution of Crohn's disease in a nonwhite population. The Montreal classification is more sensitive to behavior phenotypic changes than is the Vienna classification after excluding perianal disease from the penetrating disease category and was useful in predicting course and the need for surgery. Copyright © 2007 Crohn's & Colitis Foundation of America, Inc.en_US
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.ibdjournal.comen_US
dc.relation.ispartofInflammatory Bowel Diseasesen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAsian Continental Ancestry Groupen_US
dc.subject.meshCrohn Disease - Classification - Pathology - Surgeryen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshLongitudinal Studiesen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPhenotypeen_US
dc.titleChanges in Crohn's disease phenotype over time in the Chinese population: Validation of the Montreal classification systemen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1002/ibd.20335en_US
dc.identifier.pmid18058793en_US
dc.identifier.scopuseid_2-s2.0-42449092851en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-42449092851&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume14en_US
dc.identifier.issue4en_US
dc.identifier.spage536en_US
dc.identifier.epage541en_US
dc.identifier.isiWOS:000254783600012-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridChow, DKL=12760026500en_US
dc.identifier.scopusauthoridLeong, RWL=24343912800en_US
dc.identifier.scopusauthoridLai, LH=12759998700en_US
dc.identifier.scopusauthoridWong, GLH=9248570900en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridChan, FKL=7202586434en_US
dc.identifier.scopusauthoridSung, JJY=35405352400en_US
dc.identifier.citeulike8767990-

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