Pergialiotis Vasilios, Konstantopoulos Panagiotis, Karampetsou Nikoleta, Koutaki Diamanto, Gkioka Eleana, Perrea Despina N, Papantoniou Nikolaos
Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, National and Kapodistrian University of Athens, 6, Danaidon str., Chalandri, 15232, Athens, Greece.
Third dpt of Ob/Gyn, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Inflamm Res. 2016 Nov;65(11):847-852. doi: 10.1007/s00011-016-0963-9. Epub 2016 Jun 21.
Fecal calprotectin has been extensively investigated as a screening marker for the detection of necrotizing enterocolitis (NEC). However, there is a complete lack of consensus regarding its efficacy as a diagnostic test.
The purpose of the present systematic review is to evaluate the effectiveness of fecal calprotectin as a screening marker for the detection of NEC.
We conducted a systematic review of studies published in the Medline (1966-2016), Scopus (2004-2016), ClinicalTrials.gov (2008-2016), Cochrane Central Register of Controlled Trials CENTRAL (1999-2016), and Google Scholar (2004-2016) databases, combined with studies found in the reference lists of the included studies. All prospective and retrospective observational cohort studies were included.
Thirteen studies that included 601 neonates were identified in the international literature. The presence and severity of NEC was evaluated with the modified Bell's criteria. Ten studies found significantly elevated fecal calprotectin levels among infants with NEC (p < 0.05). One study found that this effect was observed irrespective of the stage of the disease. Five studies evaluated the efficacy of fecal calprotectin as a diagnostic test. The reported sensitivity ranged between 76 and 100 %, and the specificity varied from 39 to 96.4 %. However, the proposed cut-off values were not similar.
Current evidence suggests that fecal calprotectin is elevated in newborns suffering from NEC. However, its significance as an early screening marker remains unknown. Future studies are needed and should focus on the identification of specific cut-off values.
粪便钙卫蛋白已被广泛研究作为检测坏死性小肠结肠炎（NEC）的筛查标志物。然而，关于其作为诊断试验的有效性尚无完全一致的意见。
本系统评价的目的是评估粪便钙卫蛋白作为检测NEC筛查标志物的有效性。
我们对发表在Medline（1966 - 2016年）、Scopus（2004 - 2016年）、ClinicalTrials.gov（2008 - 2016年）、Cochrane对照试验中心注册库CENTRAL（1999 - 2016年）和谷歌学术（2004 - 2016年）数据库中的研究进行了系统评价，并结合纳入研究参考文献列表中找到的研究。纳入所有前瞻性和回顾性观察性队列研究。
在国际文献中确定了13项包括601例新生儿的研究。采用改良的贝尔标准评估NEC的存在和严重程度。10项研究发现NEC婴儿的粪便钙卫蛋白水平显著升高（p < 0.05）。一项研究发现，无论疾病阶段如何都观察到这种效应。5项研究评估了粪便钙卫蛋白作为诊断试验的有效性。报告的敏感性在76%至100%之间，特异性从39%至96.4%不等。然而，提出的临界值并不相似。
目前的证据表明，患有NEC的新生儿粪便钙卫蛋白升高。然而，其作为早期筛查标志物的意义仍不清楚。需要进一步的研究，应侧重于确定特定的临界值。
