Calafat Margalida, Cabré Eduard, Mañosa Míriam, Lobatón Triana, Marín Laura, Domènech Eugeni
*Hospital Universitari Germans Trias i Pujol, Ciberehd, Badalona, Spain; and †Universitat Autònoma de Barcelona, Barcelona, Spain.
Inflamm Bowel Dis. 2015 May;21(5):1072-6. doi: 10.1097/MIB.0000000000000349.
Fecal calprotectin (FC) is considered the best noninvasive way to assess disease activity in ulcerative colitis (UC). However, it is not known which is the more suitable moment for stool sampling in patients with increased stool frequency. The aims of this study were to assess the intraindividual variation of FC within day and to evaluate if the first bowel movement in the morning is the more suitable sample for FC measurement in patients with acute flares of UC.
Patients admitted because of active UC were invited to collect samples from several bowel movements (including the first in the morning) during the same day providing their ordinal chronology. FC was measured by means of a quantitative rapid point-of-care test based on lateral flow assay immunochromatography.
Eighteen patients were included for a total of 56 stool samples. Most patients had extensive UC and severe disease activity. Within-day FC values varied widely, and the median coefficient of variation was 40% (5%-114%) with a median range of variation of FC values of 3887 mg/kg (69-9946). The sample from the first stool in the morning obtained the highest individual FC within-day value in 33.3% of cases and the lowest in 38.9%.
FC values widely vary between motions in patients with active UC. Stool sample collection from the first bowel movement in the morning does not ensure the highest or lowest within-day FC value. In patients with overt active UC, a single FC determination should not be used as the basis for therapeutic strategies.
粪便钙卫蛋白（FC）被认为是评估溃疡性结肠炎（UC）疾病活动度的最佳非侵入性方法。然而，对于排便次数增加的患者，尚不清楚何时采集粪便样本更为合适。本研究的目的是评估FC在一天内的个体内变异，并评估晨起的第一次排便是否是UC急性发作患者测量FC的更合适样本。
因活动性UC入院的患者被邀请在同一天内从多次排便（包括晨起第一次排便）中采集样本，并提供其顺序时间。FC通过基于侧向流分析免疫层析的定量快速即时检测法进行测量。
纳入18例患者，共采集56份粪便样本。大多数患者患有广泛性UC且疾病活动度严重。一天内FC值变化很大，变异系数中位数为40%（5%-114%），FC值变异中位数范围为3887mg/kg（69-9946）。晨起第一次粪便样本在33.3%的病例中获得一天内个体FC最高值，在38.9%的病例中获得最低值。
活动性UC患者不同排便之间的FC值差异很大。晨起第一次排便采集的粪便样本并不能确保获得一天内FC的最高或最低值。对于明显活动性UC患者，不应将单次FC测定作为治疗策略的依据。
