Srivastava Saurabh, Kedia Saurabh, Kumar Sushil, Pratap Mouli Venigalla, Dhingra Rajan, Sachdev Vikas, Tiwari Veena, Kurrey Lalit, Pradhan Rajesh, Ahuja Vineet
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
J Crohns Colitis. 2015 Jul;9(7):575-9. doi: 10.1093/ecco-jcc/jjv075. Epub 2015 May 10.
The goals of treating ulcerative colitis (UC) have shifted from clinical remission to mucosal healing. Non-invasive biomarkers are required to assess mucosal healing as endoscopic assessment is inconvenient for patients. Enhanced expression of trefoil factor 3 (TFF3, a mucin-associated peptide) is observed after injury of the gastrointestinal tract. The present study was designed to evaluate TFF3 as a biomarker of mucosal healing in patients with UC.
This cross-sectional study included consecutive patients with UC (18-65 years old, disease duration >3 months, either left-sided colitis or pancolitis) who had a Simple Clinical Colitis Activity Index (SCCAI) <6. Colonoscopy was done to assess the presence or absence of mucosal healing (defined using the Baron score) in all patients. Serum level of TFF3 was assessed in all patients and 20 healthy controls.
Seventy-four patients were included [mean age 37.2±10.9 years, 47 males, median disease duration 4.8 years (IQR 3-8.3), median SCCAI = 0] in the study. Forty-three patients had mucosal healing (Baron score 0 or 1) and 31 did not (Baron score 2 or 3). Median TFF3 level in patients without mucosal healing was significantly higher than that in patients with mucosal healing [1.5 (IQR 1.2-1.9) vs 1.1 (IQR 0.8-1.3) ng/ml, p = 0.01] and healthy controls [0.85 (IQR 0.7-1.2) ng/ml, p < 0.001]. A serum TFF3 level of <1.27 ng/ml (as determined by the receiver operating characteristic curve; area under the curve 0.73) had sensitivity, specificity, positive predictive value and negative predictive value of 70, 68, 75 and 62%, respectively, for identifying patients with mucosal healing.
Serum TFF3 can potentially be used as a biomarker to assess mucosal healing in UC patients.
溃疡性结肠炎（UC）的治疗目标已从临床缓解转向黏膜愈合。由于内镜评估对患者而言不便，因此需要非侵入性生物标志物来评估黏膜愈合情况。胃肠道损伤后可观察到三叶因子3（TFF3，一种黏蛋白相关肽）表达增强。本研究旨在评估TFF3作为UC患者黏膜愈合生物标志物的价值。
这项横断面研究纳入了连续的UC患者（年龄18 - 65岁，病程>3个月，为左侧结肠炎或全结肠炎），其简单临床结肠炎活动指数（SCCAI）<6。对所有患者进行结肠镜检查以评估黏膜愈合情况（采用Baron评分定义）。评估所有患者及20名健康对照者的血清TFF3水平。
本研究纳入了74例患者[平均年龄37.2±10.9岁，男性47例，疾病持续时间中位数4.8年（四分位间距3 - 8.3），SCCAI中位数 = 0]。43例患者有黏膜愈合（Baron评分为0或1），31例患者没有（Baron评分为2或3）。无黏膜愈合患者的TFF3水平中位数显著高于有黏膜愈合患者[1.5（四分位间距1.2 - 1.9）对1.1（四分位间距0.8 - 1.3）ng/ml，p = 0.01]及健康对照者[0.85（四分位间距0.7 - 1.2）ng/ml，p < 0.001]。血清TFF3水平<1.27 ng/ml（由受试者工作特征曲线确定；曲线下面积0.73）用于识别有黏膜愈合的患者时，敏感性、特异性、阳性预测值和阴性预测值分别为70%、68%、75%和62%。
血清TFF3有可能用作评估UC患者黏膜愈合的生物标志物。
