粪便免疫化学检测作为炎症性肠病的生物标志物:它能与粪便钙卫蛋白相媲美吗?

Fecal immunochemical test as a biomarker for inflammatory bowel diseases: can it rival fecal calprotectin?

作者信息

Kato Jun, Hiraoka Sakiko, Nakarai Asuka, Takashima Shiho, Inokuchi Toshihiro, Ichinose Masao

机构信息

Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.

Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

出版信息

Intest Res. 2016 Jan;14(1):5-14. doi: 10.5217/ir.2016.14.1.5. Epub 2016 Jan 25.

Abstract

Accurate evaluation of disease activity is essential for choosing an appropriate treatment and follow-up plan for patients with inflammatory bowel disease (IBD). Endoscopy is required for accurately evaluating disease activity, but the procedures are sometimes invasive and burdensome to patients. Therefore, alternative non-invasive methods for evaluating or predicting disease activity including mucosal status are desirable. Fecal calprotectin (Fcal) is the most widely used fecal marker for IBD, and many articles have described the performance of the marker in predicting disease activity, mucosal healing (MH), treatment efficacy, and risk of relapse. Fecal immunochemical test (FIT) can quantify the concentration of hemoglobin in stool and was originally used for the screening of colorectal cancer. We recently reported that FIT is also a useful biomarker for IBD. A direct comparison between the use of Fcal and FIT showed that both methods predicted MH in ulcerative colitis equally well. However, in the case of Crohn's disease, FIT was less sensitive to lesions in the small intestine, compared to Fcal. FIT holds several advantages over Fcal in regards to user-friendliness, including a lower cost, easy and clean handling, and the ability to make rapid measurements by using an automated measurement system. However, there is insufficient data to support the application of FIT in IBD. Further studies into the use of FIT for evaluating the inflammatory status of IBD are warranted.

摘要

准确评估疾病活动度对于为炎症性肠病(IBD)患者选择合适的治疗和随访方案至关重要。准确评估疾病活动度需要进行内镜检查,但这些操作有时具有侵入性,会给患者带来负担。因此,需要其他非侵入性方法来评估或预测包括黏膜状态在内的疾病活动度。粪便钙卫蛋白(Fcal)是IBD中使用最广泛的粪便标志物,许多文章都描述了该标志物在预测疾病活动度、黏膜愈合(MH)、治疗效果和复发风险方面的表现。粪便免疫化学检测(FIT)可以定量粪便中的血红蛋白浓度,最初用于结直肠癌的筛查。我们最近报道FIT也是IBD的一种有用的生物标志物。Fcal和FIT使用情况的直接比较表明,两种方法在预测溃疡性结肠炎的MH方面同样有效。然而,在克罗恩病的情况下,与Fcal相比,FIT对小肠病变的敏感性较低。在用户友好性方面,FIT比Fcal具有几个优势,包括成本较低、操作简便且清洁,以及能够使用自动测量系统进行快速测量。然而,支持FIT在IBD中应用的数据不足。有必要进一步研究FIT在评估IBD炎症状态方面的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2fe/4754522/827306c9017c/ir-14-5-g001.jpg

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