粪便钙卫蛋白和粪便免疫化学检测对溃疡性结肠炎患者黏膜状态的临床意义。
Clinical implications of fecal calprotectin and fecal immunochemical test on mucosal status in patients with ulcerative colitis.
作者信息
Ryu Dae Gon, Kim Hyung Wook, Park Su Bum, Kang Dae Hwan, Choi Cheol Woong, Kim Su Jin, Nam Hyeong Seok
机构信息
Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea.
出版信息
Medicine (Baltimore). 2019 Sep;98(36):e17080. doi: 10.1097/MD.0000000000017080.
Although fecal calprotectin (Fcal) and the fecal immunochemical test (FIT) have been associated with endoscopic activity in ulcerative colitis (UC), the clinical implications of each marker depending on the mucosal status are not well known.A total of 174 results obtained from 128 patients with UC who simultaneously underwent colonoscopy and fecal tests were retrospectively evaluated from March 2015 to February 2018. The correlation and predictability of fecal markers as a surrogate marker of endoscopic activity, and the sensitivity, specificity, and predictive value of fecal tests for mucosal healing were statistically evaluated.Both fecal tests showed a statistically significant correlation with Mayo Endoscopic Subscore (MES) (Fcal: r = 0.678, P < .001 and FIT: r = 0.635, P < .001) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) (Fcal: r = 0.711, P < .001 and FIT: r = 0.657, P < .001). Fcal was statistically superior to FIT in predictive accuracy for endoscopic activity (area under the curve [AUC]: 0.863 vs 0.765 with MES, P < .001 and AUC; 0.847 vs 0.757 with UCEIS, P < .001). FIT was superior to Fcal in sensitivity for mucosal healing (98.0% vs 78.4% with MES, 94.9% vs 74.6% with UCEIS).Fcal and FIT were well correlated with endoscopic activity in UC and can be surrogate markers of mucosal inflammation. Depending on mucosal status, Fcal was more accurate in predicting the endoscopic activity in active inflammation, whereas FIT was more sensitive in predicting the achievement of mucosal healing.
尽管粪便钙卫蛋白(Fcal)和粪便免疫化学检测(FIT)与溃疡性结肠炎(UC)的内镜活动相关,但每种标志物根据黏膜状态的临床意义尚不清楚。对2015年3月至2018年2月期间128例同时接受结肠镜检查和粪便检测的UC患者获得的174份结果进行回顾性评估。对粪便标志物作为内镜活动替代标志物的相关性和预测性,以及粪便检测对黏膜愈合的敏感性、特异性和预测价值进行统计学评估。两种粪便检测均与梅奥内镜亚评分(MES)(Fcal:r = 0.678,P <.001;FIT:r = 0.635,P <.001)和溃疡性结肠炎内镜严重程度指数(UCEIS)(Fcal:r = 0.711,P <.001;FIT:r = 0.657,P <.001)具有统计学显著相关性。Fcal在预测内镜活动的准确性方面在统计学上优于FIT(曲线下面积[AUC]:与MES比较为0.863对0.765,P <.001;与UCEIS比较AUC为0.847对0.757,P <.001)。FIT在黏膜愈合的敏感性方面优于Fcal(与MES比较为98.0%对78.4%,与UCEIS比较为94.9%对74.6%)。Fcal和FIT与UC的内镜活动密切相关,可作为黏膜炎症的替代标志物。根据黏膜状态,Fcal在预测活动性炎症中的内镜活动方面更准确,而FIT在预测黏膜愈合的实现方面更敏感。
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