Stawczyk-Eder Kamila, Eder Piotr, Lykowska-Szuber Liliana, Krela-Kazmierczak Iwona, Klimczak Katarzyna, Szymczak Aleksandra, Szachta Patrycja, Katulska Katarzyna, Linke Krzysztof
Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland.
Institute of Microecology, Poznan, Poland.
Arch Med Sci. 2015 Apr 25;11(2):353-61. doi: 10.5114/aoms.2014.43672. Epub 2015 Apr 23.
There are data suggesting that the diagnostic usefulness of faecal calprotectin (FC) may vary depending on the Crohn's disease (CD) location. The aim of the study was to compare the diagnostic usefulness of FC in CD patients with different disease locations.
We prospectively enrolled 120 CD patients in the study. Disease activity was assessed by using Crohn's Disease Activity Index (CDAI), biochemical markers, and endoscopic and radiographic methods. Faecal calprotectin concentration was assessed in single stool samples by using the ELISA method.
Among all patients, 54 (45%) had ileocolonic CD location, 44 (36.5%) had isolated small bowel location, and 22 (18.5%) had colonic CD location. FC correlated significantly with C-reactive protein concentration and endoscopic and radiographic activity among patients with isolated small bowel CD (p = 0.03, r = 0.32; p < 0.0001, r = 0.78; p = 0.03, r = 0.35; respectively) and with C-reactive protein and endoscopic activity in isolated colonic CD (p = 0.0009, r = 0.7; p = 0.0002, r = 0.78; respectively). CDAI and inflammatory biochemical markers did not correlate with endoscopic and radiographic assessment in small bowel CD. In patients with ileocolonic CD, FC correlated significantly with endoscopy (p = 0.006, r = 0.5), radiographic assessment (p = 0.04, r = 0.3), CDAI (p = 0.0006, r = 0.5) and the majority of biochemical markers.
Faecal calprotectin is a useful diagnostic marker in all CD patients. Although its usefulness in small bowel CD seems to be the lowest, it should be utilized particularly in this disease location because of the lack of other reliable, non-invasive diagnostic methods.
有数据表明，粪便钙卫蛋白（FC）的诊断效用可能因克罗恩病（CD）的病变部位而异。本研究的目的是比较FC在不同病变部位的CD患者中的诊断效用。
我们前瞻性地招募了120例CD患者参与本研究。采用克罗恩病活动指数（CDAI）、生化指标以及内镜和影像学方法评估疾病活动度。通过酶联免疫吸附测定（ELISA）法评估单次粪便样本中的粪便钙卫蛋白浓度。
在所有患者中，54例（45%）病变位于回结肠，44例（36.5%）病变局限于小肠，22例（18.5%）病变位于结肠。在病变局限于小肠的CD患者中，FC与C反应蛋白浓度、内镜及影像学活动度显著相关（分别为p = 0.03，r = 0.32；p < 0.0001，r = 0.78；p = 0.03，r = 0.35）；在病变局限于结肠的CD患者中，FC与C反应蛋白及内镜活动度相关（分别为p = 0.0009，r = 0.7；p = 0.0002，r = 0.78）。在小肠CD患者中，CDAI和炎症生化指标与内镜及影像学评估不相关。在回结肠CD患者中，FC与内镜检查（p = 0.006，r = 0.5）、影像学评估（p = 0.04，r = 0.3）、CDAI（p = 0.0006，r = 0.5）以及大多数生化指标显著相关。
粪便钙卫蛋白在所有CD患者中都是一种有用的诊断标志物。尽管其在小肠CD中的效用似乎最低，但由于缺乏其他可靠的非侵入性诊断方法，在该病变部位尤其应使用它。
