Ryu Dae Gon, Kim Hyung Wook, Park Su Bum, Kang Dae Hwan, Choi Cheol Woong, Kim Su Jin, Nam Hyeong Seok
Dae Gon Ryu, Hyung Wook Kim, Su Bum Park, Dae Hwan Kang, Cheol Woong Choi, Su Jin Kim, Hyeong Seok Nam, Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 626-770, South Korea.
World J Gastroenterol. 2016 Dec 28;22(48):10617-10624. doi: 10.3748/wjg.v22.i48.10617.
To evaluate the efficacy of quantitative fecal immunochemical test (FIT) as biomarker of disease activity in ulcerative colitis (UC).
Between February 2013 and November 2014, a total of 82 FIT results, obtained in conjunction with colonoscopies, were retrospectivelyevaluated for 63 patients with UC. The efficacy of FIT for evaluation of disease activity was compared to colonoscopic findings. Quantitative fecal blood with automated equipment examined from collected feces. Endoscopic disease severity were assessed using the Mayo endoscopic subscore (MES) classification. The extent of disease were classified by proctitis (E1), left sided colitis (E2), and extensive colitis (E3). Clinical activity were subgrouped by remission or active.
All of 21 patients with MES 0 had negative FIT (< 7 ng/mL), but 22 patients with MES 2 or 3 had a mean FIT of > 134.89 ng/mL. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of negative FIT about mucosal healing were 73.33%, 81.82%, 91.49%, 51.43% and 73.17%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of predictive value of positive FIT (cutoff value > 100 ng/mL) about active disease status were 45.45%, 93.33%, 71.43%, 82.35% and 26.83%, respectively. Among patients with clinical remission, FIT was negative in 31 (81.6%) of 38 cases, with a mean fecal hemoglobin concentration of 6.12 ng/mL (range, negative to 80.9 ng/mL) for this group of patients. Among patients with clinical active disease, FIT was negative in 16 (36.4%) out of 44 cases, with a mean fecal hemoglobin concentration > 167.4 ng/mL for this group of patients. FIT was positively correlated with endoscopic activity ( = 0.626, < 0.01) and clinical activity ( = 0.496, < 0.01). But, FIT did not correlate with the extent of disease ( = -0.047, = 0.676).
Quantitative FIT can be a non-invasive and effective biomarker for evaluation of clinical and endoscopic activity in UC, but not predict the extent of disease.
评估定量粪便免疫化学检测（FIT）作为溃疡性结肠炎（UC）疾病活动生物标志物的疗效。
2013年2月至2014年11月期间，对63例UC患者回顾性评估了82份与结肠镜检查相关的FIT结果。将FIT评估疾病活动的疗效与结肠镜检查结果进行比较。使用自动化设备检测收集粪便中的定量粪便潜血。采用梅奥内镜亚评分（MES）分类评估内镜疾病严重程度。疾病范围分为直肠炎（E1）、左侧结肠炎（E2）和广泛性结肠炎（E3）。临床活动分为缓解期或活动期亚组。
MES为0的21例患者FIT均为阴性（<7 ng/mL），但MES为2或3的22例患者FIT平均>134.89 ng/mL。FIT阴性对黏膜愈合的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性分别为73.33%、81.82%、91.49%、51.43%和73.17%。FIT阳性（临界值>100 ng/mL）对疾病活动状态预测值的敏感性、特异性、PPV、NPV和准确性分别为45.45%；93.33%、71.43%、82.35%和26.83%。在临床缓解的患者中，38例中有31例（81.6%）FIT为阴性，该组患者粪便血红蛋白平均浓度为6.12 ng/mL（范围，阴性至80.9 ng/mL）。在临床活动期疾病患者中，44例中有16例（36.4%）FIT为阴性，该组患者粪便血红蛋白平均浓度>167.4 ng/mL。FIT与内镜活动（r = 0.626，P < 0.01）和临床活动（r = 0.496，P < 0.01）呈正相关。但是，FIT与疾病范围无关（r = -0.047，P = 0.676）。
定量FIT可作为评估UC临床和内镜活动的一种非侵入性有效生物标志物，但不能预测疾病范围。
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