Differential Diagnosis of Crohn’s Disease and Ulcerative Primary Intestinal Lymphoma: A Scoring Model Based on a Multicenter Study

Abstract

BackgroundDifferential diagnosis of Crohn’s disease (CD) and ulcerative primary intestinal lymphoma (UPIL) is a tough problem in clinical practice.AimsOur study identified key differences between CD and UPIL patients and aimed to further establish a scoring model for differential diagnosis.MethodsA total of 91 CD and 50 UPIL patients from 9 tertiary inflammatory bowel disease centers were included. Univariate and multivariate analyses were used to determine significant markers for differentiating CD and UPIL. A differential scoring model was established by logistic regression analysis.ResultsThe differential model was based on clinical symptoms, endoscopic and imaging features that were assigned different scores: intestinal bleeding (−2 points), extraintestinal manifestation (2 points), segmental lesions (1 point), cobblestone sign (2 points), homogeneous enhancement (−1 point), mild enhancement (−1 point), engorged vasa recta (1 point). A total score of ≥1 point indicates CD, otherwise UPIL was indicated. This model produced an accuracy of 83.66% and an area under the ROC curve of 0.947. The area under the ROC curve for validation using the 10-fold validation method was 0.901.ConclusionThis study provided a convenient and useful model to differentiate CD from UPIL.