. Am J Gastroenterol. 2008 Mar;103(3):649-55.The role of CARD15 mutations and smoking in the course of Crohn's disease in aMediterranean area.Renda MC, Orlando A, Civitavecchia G, Criscuoli V, Maggio A, Mocciaro F, Rossi F,Scimeca D, Modesto I, Oliva L, Cottone M.Ematologia II Ospedale V. Cervello, Palermo, Italy.AIM: To evaluate the role of CARD15 mutations and smoking in the main events ofCrohn's disease (CD).PATIENTS AND METHODS: A total of 182 patients with CD were included in aprospective study in order to evaluate the role of CARD15 mutations and smokingin the main outcomes of disease course: first operation and surgical recurrence. The following variables were evaluated in a univariable and multivariableanalysis: age, sex, site of disease, pattern, smoking habit, extraintestinalmanifestations, duration of disease, and CARD15 mutation. The Kaplan-Meier methodfor survival curves and Cox model for multivariable analysis were, respectively, used.RESULTS: A total of 110 patients were operated on and 32 were reoperated on. The 7-yr cumulative free rate of surgery was 42% (95% CI 34-51%). At multivariateanalysis only stricturing and penetrating pattern were predictors of surgery (HR 1.7, 95% CI 1-2.8; HR 3.2, CI 1.8-5.5, respectively). The 7-yr cumulative freerate of reoperation was 75% (95% CI 0.52-0.88). At multivariable analysis in the model with any CARD15 mutation, only smoking habit at diagnosis (HR 3.6, 95% CI1.4-9.1) was predictive of surgical recurrence. When single mutations wereconsidered in the model smoking (HR 4.2, 95% CI 1.8-10.1) and L1007fs mutation(HR 2.9, 95% CI 1.1-7.3) were predictive of reoperation.CONCLUSIONS: In CD, smoking predicts recurrence after surgery. The role of CARD15mutations in the clinical course of CD remains undefined.
|Rivista||American Journal of Gastroenterology|
|Stato di pubblicazione||Published - 2008|
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