Department of Internal Medicine, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
Korean J Intern Med. 2019 Jan;34(1):72-80. doi: 10.3904/kjim.2016.324. Epub 2018 Jan 20.
BACKGROUND/AIMS: Fecal calprotectin (FC) is known to correlate with disease activity and can be used as a predictor for relapse or treatment response in inflammatory bowel disease (IBD). We evaluated the usefulness of FC as a biomarker for disease activity in patients with IBD using both enzyme-linked immunosorbent assay (ELISA) and a quantitative point-of-care test (QPOCT). METHODS: Fecal samples and medical records were collected from consecutive patients with IBD. FC levels were measured by both ELISA and QPOCT and patient medical records were reviewed for clinical, laboratory, and endoscopic data. RESULTS: Ninety-three patients with IBD were enrolled, 55 with ulcerative colitis (UC) and 38 with Crohn's disease (CD). The mean FC-ELISA levels were 906.3 ± 1,484.9 μg/g in UC and 1,054.1 ± 1,252.5 μg/g in CD. There was a strong correlation between FC-ELISA level and clinical activity indices (p < 0.05). FC-ELISA level was significantly lower in patients with mucosal healing (MH) compared to those without MH in UC (85.5 ± 55.6 μg/g vs. 1,503.7 ± 2,129.9 μg/g, p = 0.005). The results from the QPOCT corresponded well to those from ELISA. A cutoff value of 201.3 μg/g for FC-ELISA and 150.5 μg/g for FC-QPOCT predicted endoscopic inflammation (Mayo endoscopic subscore ≥ 1) in UC with a sensitivity of 81.8% and 85.8%, respectively, and a specificity of 100% for both. CONCLUSION: FC was strongly associated with disease activity indices, serologic markers, and endoscopic activity in patients with IBD. QPOCT can be used more conveniently than ELISA to assess FC in clinical practice.
背景/目的:粪便钙卫蛋白(FC)与疾病活动度相关,可作为炎症性肠病(IBD)复发或治疗反应的预测指标。我们使用酶联免疫吸附测定(ELISA)和定量即时检测(QPOCT)评估 FC 作为 IBD 患者疾病活动度生物标志物的有用性。
方法:连续收集 IBD 患者的粪便样本和病历。通过 ELISA 和 QPOCT 测量 FC 水平,并回顾患者病历以获取临床、实验室和内镜数据。
结果:共纳入 93 例 IBD 患者,其中溃疡性结肠炎(UC)55 例,克罗恩病(CD)38 例。UC 患者的 FC-ELISA 平均水平为 906.3 ± 1,484.9 μg/g,CD 患者为 1,054.1 ± 1,252.5 μg/g。FC-ELISA 水平与临床活动指数呈强相关(p < 0.05)。UC 患者黏膜愈合(MH)组的 FC-ELISA 水平明显低于无 MH 组(85.5 ± 55.6 μg/g 比 1,503.7 ± 2,129.9 μg/g,p = 0.005)。QPOCT 的结果与 ELISA 结果非常吻合。FC-ELISA 的截断值为 201.3 μg/g,FC-QPOCT 的截断值为 150.5 μg/g,可分别以 81.8%和 85.8%的灵敏度预测 UC 内镜下炎症(Mayo 内镜评分≥1),特异性均为 100%。
结论:FC 与 IBD 患者的疾病活动指数、血清标志物和内镜活动密切相关。与 ELISA 相比,QPOCT 更方便用于临床实践中 FC 的评估。
Korean J Intern Med. 2018-1-20
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