Silberer Hannah, Küppers Bruno, Mickisch Oliver, Baniewicz Wojtek, Drescher Maren, Traber Lydia, Kempf Alexander, Schmidt-Gayk Heinrich
University of Heidelberg, Germany.
Clin Lab. 2005;51(3-4):117-26.
The aim of this prospective study was to compare five different leukocyte proteins in feces of patients with chronic inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and healthy persons who underwent prophylactic colonoscopy.
The leukocyte proteins calprotectin, lactoferrin, lysozyme, myeloperoxidase, and PMN-elastase were determined with immunoassays in fecal samples of three consecutive feces (e.g. three days) in 40 healthy persons, 39 patients with chronic IBD (of these 21 with Crohn's disease and 18 with ulcerative colitis), and 40 patients with IBS.
ROC curves calculated for healthy persons and patients with IBD yielded the following areas under the curves (AUCs): PMN-elastase 0.916, calprotectin 0.872, myeloperoxidase 0.750, lysozyme 0.726, and lactoferrin 0.693. The AUCs of PMN-elastase and calprotectin were not significantly different (p = 0.327), whereas PMN-elastase or calprotectin vs. the other proteins were significantly different (p < 0.001). PMN-elastase and calprotectin correlated with the endoscopically classified severity of inflammation. All fecal leukocyte markers in IBS were found in the range of the healthy persons. Data on storage stability of leukocyte proteins in fecal supernatants are given.
Fecal PMN-elastase and calprotectin support the differentiation of chronic IBD from IBS and correlate with the severity of inflammation.
本前瞻性研究的目的是比较慢性炎症性肠病（IBD）、肠易激综合征（IBS）患者以及接受预防性结肠镜检查的健康人的粪便中五种不同的白细胞蛋白。
采用免疫分析法测定40名健康人、39例慢性IBD患者（其中21例克罗恩病患者，18例溃疡性结肠炎患者）和40例IBS患者连续三天粪便样本中的白细胞蛋白钙卫蛋白、乳铁蛋白、溶菌酶、髓过氧化物酶和PMN弹性蛋白酶。
针对健康人和IBD患者计算的ROC曲线得出以下曲线下面积（AUC）：PMN弹性蛋白酶0.916、钙卫蛋白0.872、髓过氧化物酶0.750、溶菌酶0.726和乳铁蛋白0.693。PMN弹性蛋白酶和钙卫蛋白的AUC无显著差异（p = 0.327），而PMN弹性蛋白酶或钙卫蛋白与其他蛋白相比有显著差异（p < 0.001）。PMN弹性蛋白酶和钙卫蛋白与内镜分类的炎症严重程度相关。IBS患者的所有粪便白细胞标志物均在健康人范围内。给出了粪便上清液中白细胞蛋白的储存稳定性数据。
粪便PMN弹性蛋白酶和钙卫蛋白有助于区分慢性IBD和IBS，并与炎症严重程度相关。
