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粪便钙卫蛋白在评估炎症性肠病活动中的作用。

The usefulness of fecal calprotectin in assessing inflammatory bowel disease activity.

机构信息

Department of Internal Medicine, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.

出版信息

Korean J Intern Med. 2019 Jan;34(1):72-80. doi: 10.3904/kjim.2016.324. Epub 2018 Jan 20.


DOI:10.3904/kjim.2016.324
PMID:29347813
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6325438/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7470/6325438/68a233ce0955/kjim-2016-324f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7470/6325438/3059eaf73151/kjim-2016-324f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7470/6325438/b0275d4c842f/kjim-2016-324f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7470/6325438/75dac2589705/kjim-2016-324f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7470/6325438/68a233ce0955/kjim-2016-324f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7470/6325438/3059eaf73151/kjim-2016-324f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7470/6325438/b0275d4c842f/kjim-2016-324f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7470/6325438/75dac2589705/kjim-2016-324f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7470/6325438/68a233ce0955/kjim-2016-324f4.jpg

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本文引用的文献

[1]
Level of Fecal Calprotectin Correlates With Endoscopic and Histologic Inflammation and Identifies Patients With Mucosal Healing in Ulcerative Colitis.

Clin Gastroenterol Hepatol. 2015-6-4

[2]
Fecal calprotectin in diagnosis and clinical assessment of inflammatory bowel disease.

Scand J Gastroenterol. 2015-1

[3]
Mucosal healing is associated with improved long-term outcome of maintenance therapy with natalizumab in Crohn's disease.

Inflamm Bowel Dis. 2013-11

[4]
Adalimumab treatment in Crohn's disease: an overview of long-term efficacy and safety in light of the EXTEND trial.

Clin Exp Gastroenterol. 2013-8-30

[5]
A new rapid test for fecal calprotectin predicts endoscopic remission and postoperative recurrence in Crohn's disease.

J Crohns Colitis. 2013-7-1

[6]
Histologic markers of inflammation in patients with ulcerative colitis in clinical remission.

Clin Gastroenterol Hepatol. 2013-4-13

[7]
A new rapid quantitative test for fecal calprotectin predicts endoscopic activity in ulcerative colitis.

Inflamm Bowel Dis. 2013-4

[8]
Fecal calprotectin levels predict the clinical course in patients with new onset of ulcerative colitis.

Inflamm Bowel Dis. 2013-3

[9]
Fecal calprotectin more accurately reflects endoscopic activity of ulcerative colitis than the Lichtiger Index, C-reactive protein, platelets, hemoglobin, and blood leukocytes.

Inflamm Bowel Dis. 2013-2

[10]
Utility of faecal calprotectin analysis in adult inflammatory bowel disease.

World J Gastroenterol. 2012-12-14

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