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association with serum IL-32 titer and clinical manifestation of patients with CD, and identify whether serum IL-32 test is helpful in the differential diagnosis between CD and intestinal tuberculosis (ITB). Methods: Serum samples from 48 patients with CD, 46 patients with ITB and 20 normal control were collected. Serum IL-32 gamma (most active isoform of IL-32) titer was measured by IL-32 gamma specific sandwich ELISA. Results: Serum IL-32 gamma titer in patients with CD was significantly elevated compared with patients with ITB and normal control (p < 0.01). Between patients with ITB and normal control, serum IL-32 gamma titers were not significantly different. In patients with CD, serum IL-32 gamma titer tended to be increased patients with clinical symptoms such as weight loss, abdominal pain and hematochezia, and patients with lesion involved small bowel and anorectal area (p > 0.05). In patients with CD, serum IL-32 gamma titer of normal CRP group was higher than elevated CRP group, but there was no significant difference between two groups (p = 0.068). The sensitivity, specificity, positive predictive value and negative predictive value of serum IL-32 gamma titier for diagnosis of CD were 64.6%, 73.9%, 45.7% and 54.3%, respectively. Conclusions: Serum IL-32gamma titer can represent CD activity and be helpful in the differential diagnosis between CD and ITB. However, prospective large studies are needed to verify the clinical usefulness of serum IL-32gamma titer in diagnosis and monitoring of CD.

P262 Clinical outcome of perianal Crohn's disease: Natural history and impact of medical and surgical strategies over time