Natural course of ulcerative proctitis: a single-center retrospective study
10.3760/cma.j.cn101480-20240819-00093
- VernacularTitle:溃疡性直肠炎的自然病程：一项单中心回顾性研究
- Author:
Jiaming ZHOU
1
;
Jian WAN
1
;
Zhuo WANG
1
;
Hao ZHANG
1
;
Jingmin YU
1
;
Kaichun WU
1
Author Information
1. 空军军医大学西京消化病医院消化内科，西安 710032
- Publication Type:Journal Article
- Keywords:
Ulcerative proctitis;
Ulcerative colitis;
Natural disease course;
Disease extent progression;
Risk factor;
5-aminosalicylic acid
- From:
Chinese Journal of Inflammatory Bowel Diseases
2025;09(3):193-198
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the natural course of ulcerative proctitis (UP) and the risk factors associated with disease extent progression.Methods:A retrospective cohort study was conducted, including UP patients who had undergoing prospective regisration in the Department of Gastroenterology, Xijing Hospital of Digestive Diseases, Air Force Medical University between January 2000 and May 2023. All patients were ≥ 18 years old at the time of diagnosis and followed up for more than one year. The disease extent in patients at diagnosis and during follow-up was assessed according to the Montreal classification. The clinical data were compared between the progression group and the non-progression group. The cumulative proportions of disease extent progression were analyzed with the Kaplan-Meier method, and the risk factors associated with disease extent progression were analyzed with the Cox proportional hazards regression model.Results:A total of 184 UP patients were included, with a median follow-up time of 4.8 (2.8, 8.5) years. Among them, 96 were male (52.2%) and 88 were female (47.8%), with a median age at diagnosis of 39.1 (28.8, 49.7) years. At the time of diagnosis, 95 (51.6%) patients had moderate endoscopic manifestations and 64 (34.8%) had severe endoscopic manifestations, while only 25 (13.6%) patients had mild lesions. 116 patients (63.0%) experienced disease extent progression in a median time of 4.2 (1.8, 9.0) years. The cumulative proportions of disease extent progression in 1, 3, 5, and 10 years were 13.0%, 39.0%、56.7% and 78.3%, respectively. Cox regression analysis identified the use of 5-aminosalicylic acid as a protective factor against disease extent progression ( HR = 0.55, 95% CI: 0.31 ~ 0.96, P = 0.035). During follow-up, only one patient (0.5%) underwent surgery. Five patients (2.7%) were diagnosed with dysplasia, and all of these patients had experienced disease extent progression before the development of dysplasia. Conclusions:Patients with UP had a high proportion of moderate-to-severe active endoscopic findings at diagnosis, and nearly two-thirds of patients experienced disease progression during follow-up, but the rates of colectomy and neoplasia were relatively low. 5-ASA was a protective factor against disease extent progression.
