Omori Teppei, Sasaki Yu, Koroku Miki, Murasugi Shun, Yonezawa Maria, Nakamura Shinichi, Tokushige Katsutoshi
Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo 162-8666, Japan.
J Clin Med. 2022 Apr 29;11(9):2494. doi: 10.3390/jcm11092494.
Background: Small bowel (SB) lesions in quiescent Crohn’s disease (CD) are sometimes not identified by clinical activity or existing markers. We investigated the usefulness of a novel biomarker, leucine-rich α2-glycoprotein (LRG), for screening for the presence of SB ulcerative lesions detected by small-bowel capsule endoscopy (SBCE). Methods: We examined patients with a Crohn’s Disease Activity Index (CDAI) value < 150 and a C-reactive protein (CRP) value < 0.5 mg/dL with SB or SB colonic CD. The presence of small-bowel ulcerative lesions (≥0.5 cm) was grouped by SBCE results, and we then compared the groups’ LRG value to establish a cutoff value for screening for the presence of lesions. Results: In 40 patients with CD, the LRG values differed significantly between the patients with and without SB ulcerative lesions (Ul + 14.1 (2.1−16.5) μg/mL vs. Ul − 12.3 (9.3−13.5) μg/mL; p = 0.0105). The respective cutoff LRG values for the presence of SB ulcerative lesions was 14 μg/mL (areas under the ROC curve 0.77), with sensitivity 63.6%, specificity 82.8%, positive predictive values 58.3%, negative predictive values 85.7%, and accuracy 78%. Conclusion: These results indicate that LRG may be useful in predicting the presence of SB inflammation associated in patients with CD with CRP < 0.5 mg/dL and CDAI < 150, and in selecting patients for SBCE.
静止期克罗恩病（CD）的小肠（SB）病变有时无法通过临床活动或现有标志物识别。我们研究了一种新型生物标志物富含亮氨酸的α2-糖蛋白（LRG）对筛查小肠胶囊内镜（SBCE）检测到的SB溃疡性病变的有用性。方法：我们检查了克罗恩病活动指数（CDAI）值<150且C反应蛋白（CRP）值<0.5mg/dL的SB或SB结肠CD患者。根据SBCE结果对小肠溃疡性病变（≥0.5cm）的存在情况进行分组，然后比较各组的LRG值以确定筛查病变存在的临界值。结果：在40例CD患者中，有和没有SB溃疡性病变的患者之间LRG值有显著差异（有病变组14.1（2.1−16.5）μg/mL vs. 无病变组12.3（9.3−13.5）μg/mL；p = 0.0105）。SB溃疡性病变存在的LRG临界值分别为14μg/mL（ROC曲线下面积0.77），敏感性63.6%，特异性82.8%，阳性预测值58.3%，阴性预测值85.7%，准确性78%。结论：这些结果表明，LRG可能有助于预测CRP<0.5mg/dL且CDAI<150的CD患者中SB炎症的存在，并有助于选择进行SBCE的患者。
