Association Between Microscopic Lesions at Ileal Resection Margin and Recurrence After Surgery in Patients With Crohn’s Disease
Nassim Hammoudi
(1, 2)
,
Dominique Cazals-Hatem
(3)
,
Claire Auzolle
(1, 2)
,
Charlotte Gardair
(4)
,
Marjolaine Ngollo
(1)
,
Hugo Bottois
(1)
,
Stéphane Nancey
(5)
,
Benjamin Pariente
(6)
,
Anthony Buisson
(7)
,
Xavier Tréton
(8)
,
Mathurin Fumery
(9)
,
Madeleine Bezault
(1)
,
Philippe Seksik
(10)
,
Lionel Le Bourhis
(1)
,
Jean-François Fléjou
(11)
,
Matthieu Allez
(1, 2)
,
Pierre Cattan
,
Mircea Chirica
,
Nicolas Munoz-Bongrand
,
Hélène Corte
,
Nathan Beaupel
,
Jonathan Catry
,
Jean-Marc Gornet
,
Clotilde Baudry
,
Nelson Lourenco
,
Mariane Maillet
,
My-Linh Tran-Minh
,
Victor Chardiny
,
Céline Grand
,
Brice Gergaud
,
Joelle Bonnet
,
Leila Chedouba
,
Andrée Nisard
,
Laurent Beaugerie
,
Harry Sokol
,
Anne Bourrier
,
Isabelle Nion-Larmurier
,
Julien Kirchgesner
,
Elodie Quévrain
,
Loic Brot
,
Najim Chafai
,
Jérémie Lefèvre
,
Emmanuel Tiret
,
Magali Svrcek
,
Nathalie Guedj
,
Yves Panis
,
Leon Magiorri
,
Marianne Ferron
,
Yoram Bouhnik
,
Olivier Corcos
,
Carmen Stefanescu
,
Philippe Marteau
,
Xavier Dray
,
Ulrika Chaput
,
Rachid Kaci
,
Anne Dubois
,
Gilles Bommelaer
,
Marion Goutte
,
Nicolas Barnich
,
Dilek Coban
,
Catherine Godfraind
,
Juliette Joubert Zakeyh
,
Pierre Desreumaux
,
Maria Nachury
,
Coralie Sommeville
,
Florence Renaud
,
Jean-Louis Dupas
,
Julien Loreau
,
Franck Brazier
,
Denis Chatelain
,
Christophe Attencourt
,
Charles Sabbagh
,
Martine Leconte
,
Gilles Boschetti
,
Bernard Flourie
,
Yves François
,
Eddy Cotte
,
Anne Charlois
,
Peggy Falgon
,
Helena Hadjisavvas
,
Driffa Moussata
,
Marion Chauvenet
,
Sarah Boyer
,
Alexandra Traverse-Glehen
,
Xavier Hébuterne
,
Jérome Filippi
,
Paul Hofmann
,
Amine Rahili
,
Stéphanie Patouraux
,
Xavier Jouven
1
EMily (UMR_S_1160 / U1160) -
Ecotaxie, microenvironnement et développement lymphocytaire
2 Service d'hépato-gastro-entérologie
3 Département de Pathologie [Hôpital Beaujon]
4 Laboratoire de pathologie [AP-HP Hôpital Saint-Louis]
5 APY - Autophagie infection et immunité - Autophagy Infection Immunity [CIRI]
6 Service d'Hépato-gastroentérologie
7 M2iSH - Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte
8 Service de Gastroentérologie [Hôpital Beaujon]
9 Service d'Hépato Gastroenterologie [CHU Amiens-Picardie]
10 LBM UMR 7203 - Laboratoire des biomolécules
11 CHU Saint-Antoine [AP-HP]
2 Service d'hépato-gastro-entérologie
3 Département de Pathologie [Hôpital Beaujon]
4 Laboratoire de pathologie [AP-HP Hôpital Saint-Louis]
5 APY - Autophagie infection et immunité - Autophagy Infection Immunity [CIRI]
6 Service d'Hépato-gastroentérologie
7 M2iSH - Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte
8 Service de Gastroentérologie [Hôpital Beaujon]
9 Service d'Hépato Gastroenterologie [CHU Amiens-Picardie]
10 LBM UMR 7203 - Laboratoire des biomolécules
11 CHU Saint-Antoine [AP-HP]
Stéphane Nancey
- Function : Author
- PersonId : 928425
- ORCID : 0000-0003-2088-1442
Anthony Buisson
- Function : Author
- PersonId : 763185
- ORCID : 0000-0002-6347-409X
- IdRef : 167502484
Mathurin Fumery
- Function : Author
- PersonId : 774088
- ORCID : 0000-0002-2337-2902
- IdRef : 170096289
Philippe Seksik
- Function : Author
- PersonId : 761210
- IdHAL : seksik-philippe
- ORCID : 0000-0003-3596-9893
- IdRef : 085638374
Matthieu Allez
- Function : Author
- PersonId : 762385
- ORCID : 0000-0002-2012-7522
- IdRef : 050201581
Pierre Cattan
- Function : Author
Mircea Chirica
- Function : Author
Nicolas Munoz-Bongrand
- Function : Author
Hélène Corte
- Function : Author
Nathan Beaupel
- Function : Author
Jonathan Catry
- Function : Author
Jean-Marc Gornet
- Function : Author
Clotilde Baudry
- Function : Author
- PersonId : 914785
Nelson Lourenco
- Function : Author
Mariane Maillet
- Function : Author
My-Linh Tran-Minh
- Function : Author
Victor Chardiny
- Function : Author
Céline Grand
- Function : Author
Brice Gergaud
- Function : Author
Joelle Bonnet
- Function : Author
Leila Chedouba
- Function : Author
Andrée Nisard
- Function : Author
Laurent Beaugerie
- Function : Author
Harry Sokol
- Function : Author
- PersonId : 801170
- IdHAL : harry-sokol
- ORCID : 0000-0002-2914-1822
- IdRef : 128516313
Anne Bourrier
- Function : Author
Isabelle Nion-Larmurier
- Function : Author
Julien Kirchgesner
- Function : Author
- PersonId : 748817
- IdHAL : julien-kirchgesner
- ORCID : 0000-0002-2314-9284
Elodie Quévrain
- Function : Author
Loic Brot
- Function : Author
Najim Chafai
- Function : Author
Jérémie Lefèvre
- Function : Author
Emmanuel Tiret
- Function : Author
Magali Svrcek
- Function : Author
Nathalie Guedj
- Function : Author
Yves Panis
- Function : Author
- PersonId : 770596
- ORCID : 0000-0001-9553-9727
Leon Magiorri
- Function : Author
Marianne Ferron
- Function : Author
Yoram Bouhnik
- Function : Author
- PersonId : 1225458
- ORCID : 0000-0002-5787-4943
- IdRef : 059203587
Olivier Corcos
- Function : Author
Carmen Stefanescu
- Function : Author
Philippe Marteau
- Function : Author
Xavier Dray
- Function : Author
- PersonId : 1004293
Ulrika Chaput
- Function : Author
Rachid Kaci
- Function : Author
Anne Dubois
- Function : Author
Gilles Bommelaer
- Function : Author
Marion Goutte
- Function : Author
Nicolas Barnich
- Function : Author
- PersonId : 170159
- IdHAL : nicolas-barnich
- ORCID : 0000-0001-9465-7844
- IdRef : 183698770
Dilek Coban
- Function : Author
Catherine Godfraind
- Function : Author
- PersonId : 927173
- ORCID : 0000-0001-7336-2588
- IdRef : 17055614X
Juliette Joubert Zakeyh
- Function : Author
Pierre Desreumaux
- Function : Author
Maria Nachury
- Function : Author
Coralie Sommeville
- Function : Author
Florence Renaud
- Function : Author
Jean-Louis Dupas
- Function : Author
Julien Loreau
- Function : Author
Franck Brazier
- Function : Author
- PersonId : 1151134
- IdRef : 060264497
Denis Chatelain
- Function : Author
- PersonId : 1149906
- IdRef : 080482635
Christophe Attencourt
- Function : Author
- PersonId : 1149845
- ORCID : 0000-0001-9171-3521
- IdRef : 185951260
Charles Sabbagh
- Function : Author
- PersonId : 1151816
- ORCID : 0000-0001-7525-0627
- IdRef : 154808261
Martine Leconte
- Function : Author
Gilles Boschetti
- Function : Author
- PersonId : 1111135
Bernard Flourie
- Function : Author
- PersonId : 886942
Yves François
- Function : Author
Eddy Cotte
- Function : Author
- PersonId : 937059
Anne Charlois
- Function : Author
Peggy Falgon
- Function : Author
Helena Hadjisavvas
- Function : Author
Driffa Moussata
- Function : Author
Marion Chauvenet
- Function : Author
- PersonId : 906754
Sarah Boyer
- Function : Author
Alexandra Traverse-Glehen
- Function : Author
Xavier Hébuterne
- Function : Author
Jérome Filippi
- Function : Author
Paul Hofmann
- Function : Author
Amine Rahili
- Function : Author
Stéphanie Patouraux
- Function : Author
Xavier Jouven
- Function : Author
Abstract
Background and AimsDifferent types of histologic lesions at the ileal margin, detected by histology, have been associated with increased rates of recurrence after ileocaecal surgery in patients with Crohn’s disease (CD). We aimed to characterize histologic features of the ileal margin and to evaluate their association with disease recurrence.MethodsWe collected histologic data from 211 patients with ileal or ileocolonic CD who underwent ileocolonic resections at hospitals in France from September 2010 through December 2016. Ileal margins were analyzed. Early endoscopic recurrence was defined by a Rutgeerts score of i2 or more, 6 months after surgery. We also collected data from 10 adults with healthy ileum who underwent ileocecal resection for colonic tumors (controls). Clinical relapse was defined by CD-related symptoms confirmed by imaging, endoscopy, therapy intensification, CD-related complication, or subsequent surgery.ResultsSix months after surgery, 49% of patients had endoscopic recurrence; 5 years after surgery, 57% of patients had clinical relapse. Ileal margins were macroscopically affected in 20.9% of patients. CD transmural lesions at the margin (defined by mucosal ulceration or cryptitis, submucosal fibrosis and lymphoplasmacytic infiltrate of the subserosa) were observed in 13.6% of patients. Endoscopic recurrence was observed in 75% of patients with CD transmural lesions vs 46% of patients without (P =.005). In multivariate analysis, CD transmural lesions at the margin were independently associated with early endoscopic recurrence (OR, 3.83; 95% CI, 1.47-11.05; P =.008) and clinical recurrence (OR 2.04; 95% CI, 1.09-3.99; P =.026).ConclusionIn patients with CD, transmural lesions at the ileal margin were associated with an increased risk of post-operative recurrence. Histologic features of the ileal margin should be included in making decisions about post-operative therapy.
Origin | Files produced by the author(s) |
---|