血清淀粉样蛋白 A 水平与克罗恩病患者的内镜检查结果相关-评估黏膜愈合的潜在生物标志物。

Serum amyloid A level correlated with endoscopic findings in patients with Crohn's disease-Possible biomarker for evaluating mucosal healing.

机构信息

Inflammatory Bowel Disease Center, Shimane University Hospital, Izumo, Japan; Department of Internal Medicine II, Shimane University Faculty of Medicine, Izumo, Japan.

Department of Internal Medicine II, Shimane University Faculty of Medicine, Izumo, Japan.

出版信息

Dig Liver Dis. 2018 Jun;50(6):553-558. doi: 10.1016/j.dld.2017.12.010. Epub 2017 Dec 19.

DOI:10.1016/j.dld.2017.12.010

PMID:29311027

Abstract

BACKGROUND

Mucosal healing (MH) has been proposed as an essential therapeutic goal for treatment of Crohn's disease (CD) patients. The utility of serum amyloid A (SAA) for prediction of MH in CD patients is lacking.

AIMS

This study was conducted to evaluate the correlation of SAA with CD-related endoscopic disease activity.

METHODS

SAA levels in serum samples obtained from CD patients as well as endoscopic findings based on a simple endoscopic score for CD (SES-CD) were assessed in relation to CD activity index (CDAI). The diagnostic ability of MH in correlation with SAA level was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Fifty-five patients with CD were enrolled. Mean SAA level was significantly higher in clinical and endoscopic active phases as compared to an inactive phase. SAA level was also significantly correlated with SES-CD (r = 0.64, p < 0.01) and CDAI (r = 0.42, p < 0.01). The area under the ROC curve for SAA level was 0.77 and the optimal cut-off value for SAA to predict MH was 5.9 μg/dl. SAA level was shown to be associated with MH, with a sensitivity of 68% and specificity of 83%.

CONCLUSIONS

SAA may be a possible biomarker for evaluating MH in CD patients.

摘要

背景

黏膜愈合（MH）已被提议作为治疗克罗恩病（CD）患者的重要治疗目标。血清淀粉样蛋白 A（SAA）在预测 CD 患者 MH 中的作用尚不清楚。

目的

本研究旨在评估 SAA 与 CD 相关内镜疾病活动的相关性。

方法

评估了来自 CD 患者的血清样本中的 SAA 水平以及基于简单 CD 内镜评分（SES-CD）的内镜发现与 CD 活动指数（CDAI）的关系。使用受试者工作特征（ROC）曲线分析评估 MH 与 SAA 水平相关的诊断能力。

结果

共纳入 55 例 CD 患者。与非活动期相比，临床和内镜活动期的平均 SAA 水平显著升高。SAA 水平与 SES-CD（r=0.64，p<0.01）和 CDAI（r=0.42，p<0.01）也显著相关。SAA 水平的 ROC 曲线下面积为 0.77，预测 MH 的 SAA 最佳截断值为 5.9μg/dl。SAA 水平与 MH 相关，敏感性为 68%，特异性为 83%。