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Article: Changes in Crohn's disease phenotype over time in the Chinese population: Validation of the Montreal classification system
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TitleChanges in Crohn's disease phenotype over time in the Chinese population: Validation of the Montreal classification system
 
AuthorsChow, DKL1
Leong, RWL2
Lai, LH1
Wong, GLH1
Leung, WK1
Chan, FKL1
Sung, JJY1
 
Issue Date2008
 
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.ibdjournal.com
 
CitationInflammatory Bowel Diseases, 2008, v. 14 n. 4, p. 536-541 [How to Cite?]
DOI: http://dx.doi.org/10.1002/ibd.20335
 
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.
 
ISSN1078-0998
2013 Impact Factor: 5.475
 
DOIhttp://dx.doi.org/10.1002/ibd.20335
 
ISI Accession Number IDWOS:000254783600012
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorChow, DKL
 
dc.contributor.authorLeong, RWL
 
dc.contributor.authorLai, LH
 
dc.contributor.authorWong, GLH
 
dc.contributor.authorLeung, WK
 
dc.contributor.authorChan, FKL
 
dc.contributor.authorSung, JJY
 
dc.date.accessioned2012-09-05T05:28:21Z
 
dc.date.available2012-09-05T05:28:21Z
 
dc.date.issued2008
 
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.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationInflammatory Bowel Diseases, 2008, v. 14 n. 4, p. 536-541 [How to Cite?]
DOI: http://dx.doi.org/10.1002/ibd.20335
 
dc.identifier.citeulike8767990
 
dc.identifier.doihttp://dx.doi.org/10.1002/ibd.20335
 
dc.identifier.epage541
 
dc.identifier.isiWOS:000254783600012
 
dc.identifier.issn1078-0998
2013 Impact Factor: 5.475
 
dc.identifier.issue4
 
dc.identifier.pmid18058793
 
dc.identifier.scopuseid_2-s2.0-42449092851
 
dc.identifier.spage536
 
dc.identifier.urihttp://hdl.handle.net/10722/163162
 
dc.identifier.volume14
 
dc.languageeng
 
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.ibdjournal.com
 
dc.publisher.placeUnited States
 
dc.relation.ispartofInflammatory Bowel Diseases
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshAdolescent
 
dc.subject.meshAdult
 
dc.subject.meshAged
 
dc.subject.meshAsian Continental Ancestry Group
 
dc.subject.meshCrohn Disease - Classification - Pathology - Surgery
 
dc.subject.meshFemale
 
dc.subject.meshHumans
 
dc.subject.meshLongitudinal Studies
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshPhenotype
 
dc.titleChanges in Crohn's disease phenotype over time in the Chinese population: Validation of the Montreal classification system
 
dc.typeArticle
 
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<contributor.author>Wong, GLH</contributor.author>
<contributor.author>Leung, WK</contributor.author>
<contributor.author>Chan, FKL</contributor.author>
<contributor.author>Sung, JJY</contributor.author>
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<description.abstract>Background: Phenotypic evolution of Crohn&apos;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&apos;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&apos;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&apos;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 &#169; 2007 Crohn&apos;s &amp; Colitis Foundation of America, Inc.</description.abstract>
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Author Affiliations
  1. Prince of Wales Hospital Hong Kong
  2. University of New South Wales