Department of Pediatric Nephrology, Kayseri City Hospital, Kayseri, Turkey.
Department of Pediatric Gastroenterology, Başkent University Faculty of Medicine, Adana, Turkey.
Turk J Pediatr. 2020;62(6):986-993. doi: 10.24953/turkjped.2020.06.010.
Fecal calprotectin is an important inflammatory marker in intestinal diseases and is not routinely used in the upper gastrointestinal system disorders. The aim of this study was to show whether there is a relationship between fecal calprotectin levels and Helicobacter pylori (H pylori) gastritis in children and to determine the association of fecal calprotectin levels with gastric biopsy results in terms of chronic inflammation and neutrophil activity.
Patients with the complaints of the upper gastrointestinal system (epigastric pain, heartburn, nausea and vomiting) who were planned to undergo endoscopy were enrolled prospectively. The presence of H pylori was defined according to the gastric antrum biopsy results. Fecal calprotectin level was tested in the stool sample of the patients. The fecal calprotectin levels, upper gastrointestinal endoscopy and gastric biopsy results of 89 patients were evaluated.
H pylori was found to be positive in the gastric biopsies of 51 (57.3%) patients. In the H pylori positive group mean fecal calprotectin level was 74.8 ± 67 μg/g, and in the H pylori negative group mean fecal calprotectin level was 52.7 ± 46 μg/g and the difference was significant (p= 0.039). We also found a significant relationship between fecal calprotectin levels and gastric neutrophil activity grades (p= 0.034).
Mean fecal calprotectin levels were found to be higher in H pylori positive subjects in our study. Fecal calprotectin levels were correlated with gastric neutrophil activity grades. Fecal calprotectin represents gastric neutrophilic inflammation. When interpreting a high fecal calprotectin level, H pylori infection should be kept in mind.
粪便钙卫蛋白是肠道疾病中一种重要的炎症标志物,在胃肠道系统疾病中通常不使用。本研究旨在表明粪便钙卫蛋白水平与儿童幽门螺杆菌(H pylori)胃炎之间是否存在关系,并确定粪便钙卫蛋白水平与胃活检结果之间的关系,包括慢性炎症和中性粒细胞活性。
前瞻性地纳入以上消化道系统症状(上腹痛、烧心、恶心和呕吐)为主要表现计划行内镜检查的患者。根据胃窦活检结果定义 H pylori 的存在。检测患者粪便样本中的粪便钙卫蛋白水平。评估 89 例患者的粪便钙卫蛋白水平、上消化道内镜和胃活检结果。
在 51 例(57.3%)患者的胃活检中发现 H pylori 阳性。在 H pylori 阳性组,粪便钙卫蛋白水平的平均值为 74.8±67μg/g,在 H pylori 阴性组,粪便钙卫蛋白水平的平均值为 52.7±46μg/g,差异有统计学意义(p=0.039)。我们还发现粪便钙卫蛋白水平与胃中性粒细胞活性分级之间存在显著关系(p=0.034)。
在本研究中,我们发现 H pylori 阳性患者的粪便钙卫蛋白水平较高。粪便钙卫蛋白水平与胃中性粒细胞活性分级相关。粪便钙卫蛋白代表胃中性粒细胞炎症。在解释高粪便钙卫蛋白水平时,应考虑 H pylori 感染。