Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Medical School, National and Kapodistrian University of Athens, 15b Agiou Thoma Street, 11527, Athens, Greece.
Dig Dis Sci. 2013 Feb;58(2):309-19. doi: 10.1007/s10620-012-2347-5. Epub 2012 Aug 17.
Inflammatory bowel disease frequently begins during childhood or adolescence. Current tests and procedures for diagnosing and monitoring inflammatory bowel disease are invasive, uncomfortable and costly. Fecal calprotectin is an inflammatory marker tested in several studies including pediatric patients with inflammatory bowel disease.
A search for articles published up to October 2011 was conducted using MEDLINE and EMBASE databases. We included original English-written articles referred to pediatric patients with inflammatory bowel disease and measured fecal calprotectin levels. We extracted data concerning fecal calprotectin levels in patients with inflammatory bowel disease and in the controls groups, sensitivity, specificity, positive and negative likelihood ratio.
Thirty-four studies were included. Fecal calprotectin levels of patients with inflammatory bowel disease are much higher than those of healthy controls or patients with functional disorders or other gastrointestinal diseases. The results vary greatly when taking all studies into consideration. Nevertheless, in cases of newly diagnosed and/or active inflammatory bowel disease, the results are more homogeneous, with high sensitivity and positive likelihood ratio, low negative likelihood ratio, but moderate specificity. Moreover, 50 μg/g seems to be the most proper cut-off point for the fecal calprotectin test.
The fecal calprotectin test could be used for supporting diagnosis or confirming relapse of inflammatory bowel disease in pediatric patients. A positive result could confirm the suspicion of either inflammatory bowel disease diagnosis or inflammatory bowel disease relapse, due to the high sensitivity of the test, but a negative result should not exclude these conditions, due to its moderate specificity.
炎症性肠病常发生于儿童或青少年时期。目前，用于诊断和监测炎症性肠病的检测手段和程序具有侵入性、不适感强且费用高。粪便钙卫蛋白是一种炎症标志物，已在包括炎症性肠病患儿在内的多项研究中进行了检测。
我们在 MEDLINE 和 EMBASE 数据库中检索了截至 2011 年 10 月发表的文章。纳入了研究对象为炎症性肠病患儿且检测粪便钙卫蛋白水平的原始英文文献。我们提取了炎症性肠病患儿和对照组的粪便钙卫蛋白水平、敏感度、特异度、阳性似然比和阴性似然比的数据。
共纳入 34 项研究。炎症性肠病患儿的粪便钙卫蛋白水平明显高于健康对照者、功能性肠病患儿或其他胃肠道疾病患儿。综合所有研究，结果差异较大。但在新发或活动期炎症性肠病的情况下，结果更为一致，具有较高的敏感度和阳性似然比、较低的阴性似然比，但特异度中等。此外，50μg/g 似乎是粪便钙卫蛋白检测的最佳截断值。
粪便钙卫蛋白检测可用于辅助炎症性肠病患儿的诊断或确认疾病复发。由于检测具有较高的敏感度，阳性结果可支持炎症性肠病的诊断或复发，但阴性结果不能排除这些情况，因为其特异度中等。
