Chang Shannon, Malter Lisa, Hudesman David
Shannon Chang, Lisa Malter, David Hudesman, Division of Gastroenterology, New York University, New York City, NY 10016, United States.
World J Gastroenterol. 2015 Oct 28;21(40):11246-59. doi: 10.3748/wjg.v21.i40.11246.
The optimal method for monitoring quiescent disease in patients with Crohn's disease (CD) and ulcerative colitis is yet to be determined. Endoscopic evaluation with ileocolonoscopy is the gold standard but is invasive, costly, and time-consuming. There are many commercially available biomarkers that may be used in clinical practice to evaluate disease status in patients with inflammatory bowel disease (IBD), but the most widely adopted biomarkers are C-reactive protein (CRP) and fecal calprotectin (FC). This review summarizes the evidence for utilizing CRP and FC for monitoring IBD during clinical remission and after surgical resection. Endoscopic correlation with CRP and FC is evaluated in each disease state. Advantages and drawbacks of each biomarker are discussed with special consideration of isolated ileal CD. Fecal immunochemical testing, traditionally used for colorectal cancer screening, is mentioned as a potential new alternative assay in the evaluation of IBD. Based on a mixture of information gleaned from biomarkers, clinical status, and endoscopic evaluation, the best treatment decisions can be made for the patient with IBD.
监测克罗恩病（CD）和溃疡性结肠炎患者静止期疾病的最佳方法尚未确定。回结肠镜检查的内镜评估是金标准，但具有侵入性、成本高且耗时。有许多可商购的生物标志物可用于临床实践，以评估炎症性肠病（IBD）患者的疾病状态，但应用最广泛的生物标志物是C反应蛋白（CRP）和粪便钙卫蛋白（FC）。本综述总结了在临床缓解期和手术切除后利用CRP和FC监测IBD的证据。在每种疾病状态下评估了CRP和FC与内镜检查的相关性。讨论了每种生物标志物的优缺点，并特别考虑了孤立性回肠CD。传统上用于结直肠癌筛查的粪便免疫化学检测被提及为评估IBD的一种潜在新替代检测方法。基于从生物标志物、临床状态和内镜评估中收集的综合信息，可以为IBD患者做出最佳治疗决策。
