Epstein-Barr virus infection is an independent risk factor for surgery in patients with moderate-to-severe ulcerative colitis  

作　　者：Hui Zhang Xi Gu Wei He Shu-Liang Zhao Zhi-Jun Cao 

机构地区：[1]Division of Gastroenterology and Hepatology,Key Laboratory of Gastroenterology and Hepatology,Ministry of Health,Shanghai Institute of Digestive Disease,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200001,China [2]Division of Pathology,Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200001,China

出　　处：《World Journal of Gastroenterology》2025年第16期16-29,共14页世界胃肠病学杂志(英文)

基　　金：Supported by General Hospital Integrated Guidance Project of Shanghai Municipal Health Commission and Municipal Administration of Traditional Chinese Medicine(Phase I),No.ZXXT-202210;"Science and Technology Innovation Action Plan"Medical Innovation Research Project of Shanghai Municipal Science and Technology Commission,No.22Y11907900.

摘　　要：BACKGROUND Epstein-Barr virus(EBV)infection of the intestinal mucosa is associated with surgical risk in ulcerative colitis(UC);however,the exact effect remains unclear.AIM To determine whether EBV infection can predict the need for colectomy and to develop a surgical risk predictive model.METHODS This was a single-center retrospective study of 153 patients with moderate-tosevere UC between September 2012 and May 2023.EBV-encoded small RNA(EBER)in situ hybridization and immunohistochemistry(IHC)were used for EBV testing and assessment.Cytomegalovirus(CMV)was detected by IHC.Logistic regression analysis was conducted to identify risk factors for colectomy and develop a predictive risk model.RESULTS EBER-positivity in the intestinal mucosa was present in 40.4%(19/47)and 4.7%(5/106)of patients in the surgery and non-surgery groups,respectively,with significant differences between the groups(P<0.01,odds ratio=13.707).The result of multivariate logistic regression revealed that age,EBV infection in the colonic mucosa,CMV infection in the colonic mucosa,and treatment with three or more immunosuppressive agents before admission were significant independent predictors of colectomy.A nomogram incorporating these variables demonstrated good discriminative ability,and exhibited good calibration and clinical utility.IHC showed that EBV-infected cells mainly included B and T lymphocytes in patients with high EBER concentrations.CONCLUSION EBV infection of the intestinal mucosa is a significant independent risk factor for colectomy in patients with moderate-to-severe UC.The nomogram model,which includes EBV infection,effectively predicts colectomy risk.

关 键 词：Epstein-Barr virus CYTOMEGALOVIRUS Ulcerative colitis COLECTOMY Predictive model 

分 类 号：R574.62[医药卫生—消化系统]