Clinical Characteristics And Differential Diagnosis Of Crohn’s Disease And Intestinal Behcet’s Disease

Objective: Crohn’s disease(CD)and Intestinal Behcet’s Disease(i BD)are both autoimmune diseases,and intestinal Behcet’s disease(i BD)lacks diagnostic gold standards,with clinical facts of difficult differential diagnosis and a certain misdiagnosis rate.In this study,the general data,clinical manifestations,endoscopic data and histological data of patients with intestinal BD and CD were collected,and the differential diagnosis scoring standard was established to guide the clinical differential diagnosis of intestinal BD and CD.Methods:Clinical data of patients with Crohn’s disease(CD)and Intestinal Behcet’s Disease(BD)admitted to the First Department of Gastroenterology,Shengjing Hospital of China Medical University from January 1,2013 to July 30,2022 were retrospectively analyzed.The statistically significant single factor results were analyzed by multivariate analysis,and then the statistically significant variables in the multivariate analysis results were summarized to establish the differential diagnosis scoring model of the two,and the receiver operating characteristic curve(ROC curve)was drawn to calculate the sensitivity,specificity,accuracy,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio,and the sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and negative likelihood ratio.Youden index was used to determine the cut-off value for differential diagnosis.Results:In this study,106 patients with CD and 23 patients with intestinal BD were included.Statistically significant multivariate analysis results included oral ulcers,endoscopic circular ulcer and the number of ulcers.50.94% of patients with CD had more than 5 ulcers,and there was a statistically significant difference in the number of ulcers between the two patients(p=0.000).Intestinal BD was more likely to have circular ulcers(95.65% VS 39.62%,P=0.000)and oral ulcers(95.65% VS 38.68%,P= 0.000).According to the above indicators,the differential diagnosis scoring model was established.The scoring model was composed of three variables: oral ulcer,circular ulcer and the number of ulcers.The sensitivity(91.5%),specificity(82.6%),accuracy(89.9%),positive predictive value(82.6%),negative predictive value(91.5%),positive likelihood ratio(5.26),negative likelihood ratio(0.103)of the differential diagnosis model.Calculated by Youden index,-1.5 score was considered as the diagnostic critical value,>-1.5 score was diagnosed as CD,<-1.5 score was diagnosed as intestinal BD,and the area under ROC curve was 0.926(95%-CI: 0.879～0.947).HosmerLemeshow goodness of fit test was performed,and the calibration curve was obtained.The P value of goodness of fit test was 0.998 > 0.05,indicating that there was no statistical difference between the prediction model and the reality,and the conclusion proved that the accuracy of the prediction model was high.Conclusion:The diagnostic critical value of differential diagnosis scoring standard is-1.5points,>-1.5 points for CD,<-1.5 points for BD.The differential diagnosis scoring model has high diagnostic efficacy,and can be used to guide the clinical differential diagnosis of BD and CD,and can provide the basis for the differential diagnosis of BD and CD at home and abroad.