Bromke Mariusz A, Neubauer Katarzyna, Kempiński Radosław, Krzystek-Korpacka Małgorzata
Department of Biochemistry and Immunochemistry, Wroclaw Medical University, Chalubinskiego 10, 50-368 Wroclaw, Poland.
Department of Gastroenterology and Hepatology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
J Clin Med. 2021 May 19;10(10):2203. doi: 10.3390/jcm10102203.
Achieving mucosal healing in patients with inflammatory bowel disease is related to a higher incidence of sustained clinical remission and it translates to lower rates of hospitalisation and surgery. The assessment methods of disease activity and response to therapy are limited and mainly rely on colonoscopy. This meta-analysis reviews the effectiveness of using faecal calprotectin as a marker for mucosal healing in inflammatory bowel disease. Two meta-analyses were conducted in parallel. The analysis on the use of faecal calprotectin in monitoring mucosal healing in colonic Crohn's disease is based on 16 publications (17 studies). The data set for diagnostic values of faecal calprotectin in ulcerative colitis is composed of 35 original publications (total 49 studies). The DOR for the use of faecal calprotectin in Crohn's disease is estimated to be 11.20 and the area under the sROCis 0.829. In cases of ulcerative colitis, the DOR is 14.48, while the AUC sROC is 0.858. Heterogeneity of the studies was moderatetosubstantial. Collected data show overall good sensitivity and specificity of the faecal calprotectin test, as well as a good DOR. Thus, monitoring of mucosal healing with a non-invasive faecal calprotectin test may represent an attractive option for physicians and patients with inflammatory bowel disease.
在炎症性肠病患者中实现黏膜愈合与持续临床缓解的较高发生率相关，并且这意味着更低的住院率和手术率。疾病活动度和对治疗反应的评估方法有限，主要依赖结肠镜检查。这项荟萃分析回顾了使用粪便钙卫蛋白作为炎症性肠病黏膜愈合标志物的有效性。同时进行了两项荟萃分析。关于粪便钙卫蛋白在监测结肠克罗恩病黏膜愈合中的应用分析基于16篇出版物（17项研究）。溃疡性结肠炎中粪便钙卫蛋白诊断价值的数据集由35篇原始出版物（共49项研究）组成。在克罗恩病中使用粪便钙卫蛋白的诊断比值比估计为11.20，sROC曲线下面积为0.829。在溃疡性结肠炎病例中，诊断比值比为14.48，而AUC sROC为0.858。研究的异质性为中度至高度。收集的数据显示粪便钙卫蛋白检测总体具有良好的敏感性和特异性，以及良好的诊断比值比。因此，使用非侵入性的粪便钙卫蛋白检测来监测黏膜愈合对于炎症性肠病的医生和患者可能是一个有吸引力的选择。
