Garcia-Planella Esther, Mañosa Míriam, Chaparro María, Beltrán Belén, Barreiro-de-Acosta Manuel, Gordillo Jordi, Ricart Elena, Bermejo Fernando, García-Sánchez Valle, Piqueras Marta, Llaó Jordina, Gisbert Javier P, Cabré Eduard, Domènech Eugeni
a Department of Gastroenterology , Hospital Santa Creu i Sant Pau , Barcelona , Spain.
b Universitat Autònoma de Barcelona , Bellaterra , Spain.
Scand J Gastroenterol. 2018 Feb;53(2):152-157. doi: 10.1080/00365521.2017.1410219. Epub 2017 Nov 30.
Fecal calprotectin (FC) correlates with clinical and endoscopic activity in ulcerative colitis (UC), and it is a good predictor of relapse. However, its use in clinical practice is constrained by the need for the patient to deliver stool samples, and for their handling and processing in the laboratory. The availability of hand held devices might spread the use of FC in clinical practice.
To evaluate the usefulness of a rapid semi-quantitative test of FC in predicting relapse in patients with UC in remission.
Prospective, multicenter study that included UC patients in clinical remission for ≥6 months on maintenance treatment with mesalamine. Patients were evaluated clinically and semi-quantitative FC was measured using a monoclonal immunochromatography rapid test at baseline and every three months until relapse or 12 months of follow-up.
One hundred and ninety-one patients had at least one determination of FC. At the end of follow-up, 33 patients (17%) experienced clinical relapse. Endoscopic activity at baseline (p = .043) and having had at least one FC > 60 μg/g during the study period (p = .03) were associated with a higher risk of relapse during follow-up. We obtained a total of 636 semi-quantitative FC determinations matched with a three-month follow-up clinical assessment. Having undetectable FC was inversely associated with early relapse (within three months), with a negative predictive value of 98.6% and a sensitivity of 93.9%.
Serial, rapid semi-quantitative measurement of FC may be a useful, easy and cheap monitoring tool for patients with UC in remission.
粪便钙卫蛋白（FC）与溃疡性结肠炎（UC）的临床及内镜活动相关，是复发的良好预测指标。然而，其在临床实践中的应用受到限制，因为患者需要提供粪便样本，且实验室需对样本进行处理。手持设备的出现可能会推广FC在临床实践中的应用。
评估FC快速半定量检测对预测缓解期UC患者复发的有效性。
一项前瞻性多中心研究，纳入接受美沙拉嗪维持治疗且临床缓解≥6个月的UC患者。对患者进行临床评估，并在基线时及之后每三个月使用单克隆免疫层析快速检测法测量半定量FC，直至复发或随访12个月。
191例患者至少进行了一次FC测定。随访结束时，33例患者（17%）出现临床复发。基线时内镜活动情况（p = 0.043）以及研究期间至少有一次FC>60μg/g（p = 0.03）与随访期间较高复发风险相关。我们共获得636次半定量FC测定结果，并与为期三个月的随访临床评估结果相匹配。FC检测不到与早期复发（三个月内）呈负相关，阴性预测值为98.6%，灵敏度为93.9%。
对缓解期UC患者进行连续、快速半定量FC检测可能是一种有用、简便且廉价的监测工具。
