الفهرس 
Inflammatory Bowel Disease (IBD)Only 14 pages are availabe for public view
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Abstract
Colon diseases, such as colitis, salmonellosis, shigellosis, travellers’
diarrhoea, diverticular disease (DD), inflammatory bowel syndrome (IBS),
inflammatory bowel disease (IBD), and colorectal cancer, have a significant
global impact on both men’s and women’s health (CRC). Environmental and
genetic factors influence the onset and progression of many colonic diseases.
IBD is a chronic inflammatory disease of the gastrointestinal tract,
characterized by repetitive episodes of inflammation of the gastrointestinal
tract caused by an abnormal immune response to gut microflora. IBD is
classified into two subtypes: ulcerative colitis (UC) and Crohn’s disease
(CD).
In addition, one of the most common gastrointestinal diseases is irritable
bowel syndrome (IBS). IBS is defined as the presence of abdominal pain or
discomfort with altered bowel habits in the absence of any other underlying
disease. Since its discovery, IBS diagnosis has evolved, and today the Rome
IV diagnostic criteria are used to diagnose IBS. Symptoms of IBS can be
managed with a variety of medications and nonpharmaceutical agents,
depending on the subclass. Nonetheless, IBS treatment should be tailored to
the individual, and a strong patient-physician relationship remains an
important factor in management.
Colorectal cancer (CRC) is the most common malignancy of the
gastrointestinal tract/bowel or large intestine, the third most common cancer
diagnosed, and the third leading cause of cancer-related death worldwide.
CRC is frequently regarded as a common disease affecting the elderly, with
the majority of cases studied between the fifth and sixth decades and a male
predominance. It is a multifactorial disease process, with genetic factors,
environmental exposures (including diet), and inflammatory conditions of the
digestive tract all contributing to its aetiology.
Systemic inflammation is associated with changes in quantity and
composition of circulating blood cells. Recent studies have reported that the
number and ratio of complete blood cell (CBC) subset in inflammatory
diseases. Red blood cell distribution width (RDW), an indicator of the size
variability of circulating red blood cells, has been associated with various
inflammatory conditions.
Platelet distribution width (PDW) is a marker of platelet unequal red
blood cells, which describes the size distribution of platelets produced by
megakaryocytes and increases with platelet activation. PDW has been
associated with coronary heart disease, liver steatosis, irritable bowel
syndrome and diabetic nephropathy. All of these diseases are related with
increased inflammation.
So, the present study aimed to evaluate the utility of Red Cell
Distribution Width (RDW), Mean Platelet Volume (MPV) and Platelet
Distribution Width (PDW) as potential laboratory non invasive biomarkers in
colonic diseases patients (Irritable bowel syndrome and inflammatory bowel
disease and cancer colon patients).
The present case control study included 300 patients have symptoms and
clinical signs of colonic diseases, were diagnosed by colonoscopy
examination by expert gastroenterologists, they were divided into 100
patients with irritable bowel disease, 100 patients with inflammatory bowel
disease, 100 patients with cancer colon compared to healthy controls in
Menoufia Faculty of Medicine Hospital from Oct. 2021 to Feb. 2023
Regarding platelet count in the present study, IBD group only showed
significantly higher platelet count when compared to control group. While
MPV was significantly lower among IBS and IBD, significantly higher
cancer colon groups when compared to control group.
Regarding the inflammatory markers in the current study, IBD and
cancer colon groups sowed significantly higher ESR when compared to
control group, while all colonic diseases groups showed significantly higher
CRP when compared to control group.
Regarding IBD in our study, MPV and PDW was significantly lower in
active versus remitted UC and CD as well as in active versus remitted CD.
While MPV and PDW did not differ significantly between UC versus CD
cases. RDW-CV did not differ significantly between UC versus CD, neither
remitted nor relapsed.
Regarding colon cancer cases, RDW-CV did not differ significantly
between grades of endoscopy, Tumor stages, nodal stages, or metastatic
stages. While MPV and PDW significantly lower in II and III grades when
compared to I grade. PDW tend to decrease significantly with increased
tumour stages, nodal stages, and metastasis stages.
For discrimination between IBS patients and control group. RDW
showed high accuracy AUC, while MPV and PDW showed moderate
accuracy AUCs. While for discrimination between IBD patients and control
group. RDW and MPV showed moderate accuracy. While PDW showed low
accuracy AUC for discrimination between cancer colon patients and control
group. RDW showed moderate accuracy AUCs While MPV and PDW
showed low accuracy AUCs.
For discrimination between active and remitted IBD in our study, PDW
showed high accuracy AUC, MPV showed moderate accuracy AUC. While
RDW showed low accuracy AUC.
The current study showed that higher ESR, CRP, MPV, were considered
cancer colon risk predictors on top of IBS. Moreover, higher ESR, MPV,
PDW were considered cancer colon risk predictors on top of IBD. While
higher RDW, lower PDW were considered risk predictors for higher cancer
stage.