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

File Download Links for fulltext
(May Require Subscription)
Supplementary
  • Basic View
  • Metadata View
  • XML View
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
2011 Impact Factor: 4.855
2011 SCImago Journal Rankings: 0.400
DOIhttp://dx.doi.org/10.1002/ibd.20335
ReferencesReferences in Scopus
DC Field
Value
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.issn1078-0998
2011 Impact Factor: 4.855
2011 SCImago Journal Rankings: 0.400
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
Author Affiliations
  1. Prince of Wales Hospital Hong Kong
  2. University of New South Wales