Cellular Pathology, Southmead Hospital, Bristol, UK
Immunology, Southmead Hospital, Bristol, UK.
J Clin Pathol. 2022 Mar;75(3):205-208. doi: 10.1136/jclinpath-2020-207343. Epub 2021 Jan 28.
Faecal calprotectin (FCP) measurement is used especially to investigate for inflammatory bowel disease (IBD). To assess the utility of sampling endoscopically normal large bowel among patients first presenting with elevated FCP, this study identified 115 such patients out of 652 patients with elevated FCP from approximately 6000 primary care tests processed over 15 months.
23 cohort patients showed histologically abnormal large bowel biopsies. Only four cases demonstrated acute inflammation and two such patients only showed scattered cryptitis and did not develop IBD. A third patient demonstrated similar histology but, following repeat colonoscopy, her elevated FCP was attributed to small intestinal inflammation. Only the fourth patient's large bowel biopsies showed features suggesting Crohn's disease, but this represented an IBD detection rate out of 115 sets of large bowel biopsies of 0.9%.
Sampling of endoscopically normal large bowel among patients first presenting with elevated FCP is not clinically justified.
粪便钙卫蛋白（FCP）检测特别用于炎症性肠病（IBD）的研究。为了评估在首次出现 FCP 升高的患者中，对内镜下正常大肠进行取样的效用，本研究从大约 6000 例在 15 个月内处理的初级保健检测中，共检测到 652 例 FCP 升高的患者，其中识别出 115 例此类患者。
23 例队列患者的大肠活检显示组织学异常。仅有 4 例表现为急性炎症，其中 2 例仅表现为散在的隐窝炎，并未发展为 IBD。第 3 例患者的组织学表现相似，但在重复结肠镜检查后，其升高的 FCP 被归因于小肠炎症。仅第 4 例患者的大肠活检显示出提示克罗恩病的特征，但这代表在 115 例大肠活检中，IBD 的检出率为 0.9%。
对于首次出现 FCP 升高的患者，对内镜下正常大肠进行取样在临床上是不合理的。
