Suárez Ferrer Cristina, Abadía Barno Marta, Martín Arranz Eduardo, Jochems Andrea, García Ramírez Laura, Poza Cordón Joaquín, Jaquotot Herranz Marta, Cerpa Arencibia Alberto, Martín Arranz María Dolores
Aparato Digestivo, Hospital Universitario La Paz, ESPAÑA.
Aparato Digestivo, Hospital Universitario La Paz.
Rev Esp Enferm Dig. 2019 Oct;111(10):744-749. doi: 10.17235/reed.2019.5797/2018.
simple, reliable and non-invasive biomarkers are needed to enable the early detection of inflammatory activity for the correct management of inflammatory bowel disease (IBD). One of these biomarkers may be serum calprotectin (SC).
a prospective study was performed of patients with IBD due to undergo a colonoscopy as part of the common clinical practice. The study parameters included SC, fecal calprotectin (FC) and conventional blood test parameters. Clinical indices (Harvey and Walmsley) and relevant endoscopic scores were completed for each scenario (Simple Endoscopic Score Crohn Disease [SES-CD] and Mayo).
fifty-three patients were included in the study, 51% (27 patients) with ulcerative colitis (UC) and 49% (26 patients) with Crohn's disease (CD). The CS values in UC were significantly higher with an endoscopic Mayo score 2/3 (median score 10.39 mg/ml [IQR: 7.4-12.2]) compared to those with a Mayo score of 0/1 (median 4.07 mg/ml [IQR: 2.9-7.2]) (p = 0.01). The area under the ROC curve (AUCROC) was 0.85 and the sensitivity and specificity were 83.3% and 81.25%, respectively, for a SC cut-off point of 4.4 mg/dl. Furthermore, a higher AUCROC was obtained in comparison with other serological markers for activity (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR], hemoglobin [Hb] and platelets). There were no statistically significant differences in the comparison between SC and endoscopic findings in CD (SES CD > 3: 20.1 [IQR: 16.8-23.4] vs SESC ≤ 3:6.25 [IQR: 5.4-7.1]) (p = 0.8).
SC is a good indirect marker of inflammatory activity and there was a correlation with endoscopic findings in UC. However, there were no statistically significant differences in the case of CD.
需要简单、可靠且无创的生物标志物来实现炎症性肠病（IBD）炎症活动的早期检测，以进行正确管理。血清钙卫蛋白（SC）可能是其中一种生物标志物。
对因结肠镜检查而接受检查的IBD患者进行了一项前瞻性研究，结肠镜检查是常见临床实践的一部分。研究参数包括SC、粪便钙卫蛋白（FC）和常规血液检测参数。针对每种情况（克罗恩病简易内镜评分[SES-CD]和梅奥评分）完成临床指标（哈维和沃尔姆斯利）及相关内镜评分。
53例患者纳入研究，其中51%（27例）为溃疡性结肠炎（UC），49%（26例）为克罗恩病（CD）。与梅奥评分为0/1（中位数4.07 mg/ml[四分位间距：2.9 - 7.2]）的患者相比，梅奥内镜评分为2/3（中位数评分10.39 mg/ml[四分位间距：7.4 - 12.2]）的UC患者的CS值显著更高（p = 0.01）。对于SC临界值为4.4 mg/dl，ROC曲线下面积（AUCROC）为0.85，敏感性和特异性分别为83.3%和81.25%。此外，与其他活动血清学标志物（C反应蛋白[CRP]、红细胞沉降率[ESR]、血红蛋白[Hb]和血小板）相比，获得了更高的AUCROC。在CD中，SC与内镜检查结果的比较无统计学显著差异（SES CD > 3：20.1[四分位间距：16.8 - 23.4] vs SESC ≤ 3：6.25[四分位间距：5.4 - 7.1]）（p = 0.8）。
SC是炎症活动的良好间接标志物，且与UC的内镜检查结果相关。然而，在CD病例中无统计学显著差异。
