Hovstadius Henrik, Lundgren David, Karling Pontus
Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden.
Inflamm Intest Dis. 2021 May;6(2):101-108. doi: 10.1159/000513473. Epub 2021 Feb 17.
Faecal calprotectin (FC) is commonly used as a diagnostic tool for patients with gastrointestinal (GI) symptoms. However, there is uncertainty in daily clinical practice how to interpret an elevated FC in patients with a normal colonoscopy. We investigated if patients with a normal colonoscopy but with an elevated FC more often were diagnosed with a GI disease in a 3-year follow-up period.
Patients referred for colonoscopy ( = 1,263) to the Umeå University Hospital endoscopy unit between 2007 and 2013 performed a FC test (CALPRO) on the day before bowel preparation. A medical chart review was performed on all patients who had normal findings on their colonoscopy ( = 585, median age 64 years).
Thirty-four percent of the patients ( = 202) with normal colonoscopy had elevated FC (>50 μg/g), and these patients were more frequently diagnosed with upper GI disease during the follow-up period than patients with normal FC levels (9.9 vs. 4.7%; = 0.015). The upper GI diseases were mainly benign (i.e., gastritis). In a binary logistic regression analysis controlling for age, gender, nonsteroid anti-inflammatory drug use, and proton-pump inhibitor use, there was no difference for a new diagnosis of upper GI disease in the follow-up period (multivariate OR 1.70; 95% CI: 0.77-3.74). There was no difference in a new diagnosis of lower GI disease (6.4 vs. 5.2%; = 0.545) or cardiovascular disease/death (multivariate OR 1.68; 95% CI: 0.83-3.42) in the follow-up period between patients with elevated versus normal FC levels.
In patients with a normal colonoscopy, a simultaneously measured increased FC level was not associated with an increased risk for significant GI disease during a follow-up period of 3 years.
粪便钙卫蛋白（FC）常用于有胃肠道（GI）症状患者的诊断工具。然而，在日常临床实践中，对于结肠镜检查正常但FC升高的患者如何解读存在不确定性。我们调查了结肠镜检查正常但FC升高的患者在3年随访期内是否更常被诊断出患有胃肠道疾病。
2007年至2013年间转诊至于默奥大学医院内镜科进行结肠镜检查（n = 1263）的患者在肠道准备前一天进行了FC检测（CALPRO）。对所有结肠镜检查结果正常的患者（n = 585，中位年龄64岁）进行了病历审查。
结肠镜检查正常的患者中有34%（n = 202）的FC升高（>50μg/g），在随访期间，这些患者比FC水平正常的患者更常被诊断出患有上胃肠道疾病（9.9%对4.7%；P = 0.015）。上胃肠道疾病主要为良性（即胃炎）。在控制年龄、性别、非甾体抗炎药使用和质子泵抑制剂使用的二元逻辑回归分析中，随访期内新诊断上胃肠道疾病无差异（多变量OR 1.70；95%CI：0.77 - 3.74）。随访期内，FC升高与正常的患者在新诊断下胃肠道疾病（6.4%对5.2%；P = 0.545）或心血管疾病/死亡（多变量OR 1.68；95%CI：0.83 - 3.42）方面无差异。
在结肠镜检查正常的患者中，同时测量的FC水平升高与3年随访期内严重胃肠道疾病风险增加无关。
