粪便免疫化学试验和粪便钙卫蛋白检测结果在溃疡性结肠炎的疾病监测中呈现不同特征。

Fecal Immunochemical Test and Fecal Calprotectin Results Show Different Profiles in Disease Monitoring for Ulcerative Colitis.

机构信息

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

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

出版信息

Gut Liver. 2018 Mar 15;12(2):142-148. doi: 10.5009/gnl17013.

BACKGROUND/AIMS: Both fecal immunochemical test (FIT) and fecal calprotectin (Fcal) results are useful biomarkers for ulcerative colitis (UC). However, the situations in which each marker should be used are largely unknown.

METHODS

A total of 110 colonoscopy intervals of UC patients were assessed, and correlations between changes in colonoscopic findings and changes in the two aforementioned fecal markers were examined.

RESULTS

Among patients with mucosal healing (MH) and negative FIT or Fcal results at the initial colonoscopy, FIT and Fcal findings exhibited accuracies of 93% (38/41) and 79% (26/33), respectively, for predicting the results of the subsequent examination. Among the 24 patients who showed endoscopic activity at the precedent colonoscopy and MH at the subsequent examination, positive-to-negative conversion of FIT and Fcal findings at the subsequent examination was observed in 92% (12/13) and 62% (8/13) of patients, respectively. Among the 43 patients who showed endoscopic activity at both the precedent and subsequent examinations, Fcal findings reflected the change in endoscopic activity better than FIT results (r=0.59, p＜0.0001 vs r=0.30, p=0.054).

CONCLUSIONS

The FIT is useful for confirming MH and the occurrence of relapse. In contrast, Fcal is useful for monitoring the mucosal status of patients with active inflammation.

背景/目的：粪便免疫化学检测（FIT）和粪便钙卫蛋白（Fcal）检测结果均是溃疡性结肠炎（UC）有用的生物标志物。然而，对于每种标志物应该在何种情况下使用，目前仍知之甚少。

方法

评估了 110 例 UC 患者的结肠镜检查间隔，检测了结肠镜检查结果变化与上述两种粪便标志物变化之间的相关性。

结果

在初始结肠镜检查时黏膜愈合（MH）且 FIT 和 Fcal 检测结果均为阴性的患者中，FIT 和 Fcal 检测结果对于预测后续检查结果的准确性分别为 93%（38/41）和 79%（26/33）。在 24 例先前结肠镜检查有内镜活动且随后检查 MH 的患者中，FIT 和 Fcal 检测结果在随后的检查中由阳性转为阴性的比例分别为 92%（12/13）和 62%（8/13）。在 43 例先前和随后的结肠镜检查均有内镜活动的患者中，Fcal 检测结果比 FIT 结果更能反映内镜活动的变化（r=0.59，p＜0.0001 比 r=0.30，p=0.054）。