title: Potential model for differential diagnosis between Crohn's disease and primary intestinal lymphoma.
abstract: OBJECTIVE
  To evaluate the usefulness of different parameters to differentiate Crohn's disease (CD) from primary intestinal lymphoma (PIL).
  
  
  METHODS
  The medical records of 85 patients with CD and 56 patients with PIL were reviewed retrospectively. Demographic, clinical, laboratory, endoscopic, and computed tomographic enterography (CTE) parameters were collected. The univariate value of each parameter was analyzed. A differentiation model was established by pooling all the valuable parameters. Diagnostic efficacy was analyzed, and a receiver operating characteristic (ROC) curve was plotted.
  
  
  RESULTS
  The demographic and clinical parameters that showed significant values for differentiating CD from PIL included age of onset, symptom duration, presence of diarrhea, abdominal mass, and perianal lesions (P< 0.05). Elevated lactate dehydrogenase and serum β2-microglobulin levels suggested a PIL diagnosis (P< 0.05). The endoscopic parameters that showed significant values for differentiating CD from PIL included multiple-site lesions, longitudinal ulcer, irregular ulcer, and intraluminal proliferative mass (P< 0.05). The CTE parameters that were useful in the identification of the two conditions included involvement of ≤ 3 segments, circular thickening of the bowel wall, wall thickness > 8 mm, aneurysmal dilation, stricture with proximal dilation, "comb sign", mass showing the "sandwich sign", and intussusceptions (P< 0.05). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the differentiation model were 91.8%, 96.4%, 93.6%, 97.5%, and 88.5%, respectively. The cutoff value was 0.5. The area under the ROC curve was 0.989.
  
  
  CONCLUSIONS
  The differentiation model that integrated the various parameters together may yield a high diagnostic efficacy in the differential diagnosis between CD and PIL.
authors.affiliation: Tian-Yu Zhang, Yun Lin, Rong Fan, Shu-Rong Hu, Meng-Meng Cheng, Mao-Chen Zhang, Li-Wen Hong, Xiao-Lin Zhou, Zheng-Ting Wang, Jie Zhong, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Tian-Yu
authors.initials: TY
authors.lastname: Zhang
authors.affiliation: Tian-Yu Zhang, Yun Lin, Rong Fan, Shu-Rong Hu, Meng-Meng Cheng, Mao-Chen Zhang, Li-Wen Hong, Xiao-Lin Zhou, Zheng-Ting Wang, Jie Zhong, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Tian-Yu Zhang, Yun Lin, Rong Fan, Shu-Rong Hu, Meng-Meng Cheng, Mao-Chen Zhang, Li-Wen Hong, Xiao-Lin Zhou, Zheng-Ting Wang, Jie Zhong, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Fan
authors.affiliation: Tian-Yu Zhang, Yun Lin, Rong Fan, Shu-Rong Hu, Meng-Meng Cheng, Mao-Chen Zhang, Li-Wen Hong, Xiao-Lin Zhou, Zheng-Ting Wang, Jie Zhong, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Shu-Rong
authors.initials: SR
authors.lastname: Hu
authors.affiliation: Tian-Yu Zhang, Yun Lin, Rong Fan, Shu-Rong Hu, Meng-Meng Cheng, Mao-Chen Zhang, Li-Wen Hong, Xiao-Lin Zhou, Zheng-Ting Wang, Jie Zhong, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Meng-Meng
authors.initials: MM
authors.lastname: Cheng
authors.affiliation: Tian-Yu Zhang, Yun Lin, Rong Fan, Shu-Rong Hu, Meng-Meng Cheng, Mao-Chen Zhang, Li-Wen Hong, Xiao-Lin Zhou, Zheng-Ting Wang, Jie Zhong, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Mao-Chen
authors.initials: MC
authors.lastname: Zhang
authors.affiliation: Tian-Yu Zhang, Yun Lin, Rong Fan, Shu-Rong Hu, Meng-Meng Cheng, Mao-Chen Zhang, Li-Wen Hong, Xiao-Lin Zhou, Zheng-Ting Wang, Jie Zhong, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Li-Wen
authors.initials: LW
authors.lastname: Hong
authors.affiliation: Tian-Yu Zhang, Yun Lin, Rong Fan, Shu-Rong Hu, Meng-Meng Cheng, Mao-Chen Zhang, Li-Wen Hong, Xiao-Lin Zhou, Zheng-Ting Wang, Jie Zhong, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Xiao-Lin
authors.initials: XL
authors.lastname: Zhou
authors.affiliation: Tian-Yu Zhang, Yun Lin, Rong Fan, Shu-Rong Hu, Meng-Meng Cheng, Mao-Chen Zhang, Li-Wen Hong, Xiao-Lin Zhou, Zheng-Ting Wang, Jie Zhong, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Zheng-Ting
authors.initials: ZT
authors.lastname: Wang
authors.affiliation: Tian-Yu Zhang, Yun Lin, Rong Fan, Shu-Rong Hu, Meng-Meng Cheng, Mao-Chen Zhang, Li-Wen Hong, Xiao-Lin Zhou, Zheng-Ting Wang, Jie Zhong, Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhong
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D002681:China / Q000453:epidemiology; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D003424:Crohn Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008223:Lymphoma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: CT enterography; Crohn’s disease; Differential diagnosis; Endoscopy; Primary intestinal lymphoma