Department of Gastroenterology and Hepatology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Nanjing, 210002, Jiangsu Province, China.
Department of Gastroenterology and Hepatology, Jinling Hospital, Clinical Medical School of Southern Medical University, Nanjing, 210002, China.
Sci Rep. 2017 May 16;7(1):1970. doi: 10.1038/s41598-017-02111-6.
Few studies have evaluated the usefulness of fecal calprotectin (FC) or magnetic resonance enterography (MRE) in diagnosing active Crohn's disease (CD) of the small bowel. In the study, we investigated the reliability of FC and MRE in assessing the activity of ileal CD and further explored the relationship between levels of FC and MRE scores. A total of 221 patients were diagnosed with ileal or ileo-colitis CD in our department between July 2012 and October 2016. The global magnetic resonance index of activity (MaRIA) correlated with the simple endoscopic score for CD (SES-CD) (r = 0.527, P = 0.005). When analysed segment-by-segment, a significant correlation was still observed (r = 0.590, P < 0.001). The SES-CD correlated closest with FC (r = 0.503), followed by CRP (r = 0.461), ESR (0.377) and the CDAI (r = 0.320). In receiver operating characteristic (ROC) analyses, the FC cut-off value of mucosal healing was 213.1 μg/g, with 76.1% sensitivity and 66.7% specificity. As for MaRIA, a cut-off value of 6.8 for each segment provided a sensitivity of 100% and a specificity of 79.2%. No agreement between MaRIA and FC levels was found. In conclusion, a combination of FC levels and MaRIA could be effective in monitoring mucosal activity in patients with small bowel CD.
很少有研究评估粪便钙卫蛋白(FC)或磁共振肠造影(MRE)在诊断小肠活动性克罗恩病(CD)中的作用。在本研究中,我们调查了 FC 和 MRE 在评估回肠 CD 活性方面的可靠性,并进一步探讨了 FC 水平与 MRE 评分之间的关系。2012 年 7 月至 2016 年 10 月期间,我院共诊断出 221 例回肠或回结肠 CD 患者。总体磁共振活动指数(MaRIA)与简单内镜 CD 评分(SES-CD)呈正相关(r=0.527,P=0.005)。分段分析时,仍观察到显著相关性(r=0.590,P<0.001)。SES-CD 与 FC 相关性最强(r=0.503),其次是 CRP(r=0.461)、ESR(0.377)和 CDAI(r=0.320)。在受试者工作特征(ROC)分析中,黏膜愈合的 FC 截断值为 213.1μg/g,其敏感性为 76.1%,特异性为 66.7%。对于 MaRIA,每个节段的截断值为 6.8,其敏感性为 100%,特异性为 79.2%。未发现 MaRIA 与 FC 水平之间存在一致性。总之,FC 水平与 MaRIA 联合使用可能有助于监测小肠 CD 患者的黏膜活性。