Department of Surgery, Department of Medicine, Kurume University School of Medicine.
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine.
Kurume Med J. 2022 Nov 16;67(2.3):57-63. doi: 10.2739/kurumemedj.MS6723005. Epub 2022 Aug 10.
Fecal calprotectin (FC) is the most widely used marker for evaluating the disease activity of ulcerative colitis (UC). However, studies on FC in pouchitis after total proctocolectomy are scarce. We aimed to examine the correlations between the FC level and clinical findings and Pouchitis Disease Activity Index (PDAI) in UC patients who underwent total proctocolectomy (TP) with ileal pouch-anal canal anastomosis (IPAA) or ileal pouch-anal canal anastomosis (IACA).
Between April 2008 and March 2018, 15 patients, consisting of 8 males and 7 females, with an average age at operation of 46.5 years, participated in this study. The average observation period was 68.3 months. The subjects underwent FC level measurements and endoscopic examinations.
The mean FC level was 418.69 μg/g (range: 10-1650 μg/g). Pouchitis was found in one (6.6%) patient, as detected by endoscopy. Among the 15 cases, FC levels were positively correlated with white blood cell count as well as albumin and C-reactive protein levels. There was a significant positive correlation between the PDAI score and FC levels (p<0.05). The median FC level was 111 mg/g in those with pouchitis, which was significantly higher than the 16 mg/g in those without pouchitis (p<0.05). Moreover, a significant positive correlation was found between the endoscopic findings of inflammation and FC levels (p<0.00005).
FC levels were correlated with the PDAI score, blood testing data, and endoscopic findings, suggesting that the FC level could be a useful index of postoperative pouchitis and ileal pouch condition in patients undergoing TP with IPAA as UC treatment.
粪便钙卫蛋白（FC）是评估溃疡性结肠炎（UC）疾病活动度最常用的标志物。然而，全直肠结肠切除术后 pouchitis 的 FC 研究很少。我们旨在研究 FC 水平与接受全直肠结肠切除（TP）加回肠贮袋-肛管吻合术（IPAA）或回肠贮袋-肛管吻合术（IACA）的 UC 患者的临床发现和 pouchitis 疾病活动指数（PDAI）之间的相关性。
2008 年 4 月至 2018 年 3 月，共有 15 例患者（男 8 例，女 7 例），平均手术年龄 46.5 岁，平均观察时间 68.3 个月。患者进行 FC 水平测量和内镜检查。
FC 水平平均值为 418.69 μg/g（范围：10-1650 μg/g）。内镜发现 pouchitis 1 例（6.6%）。15 例中，FC 水平与白细胞计数以及白蛋白和 C 反应蛋白水平呈正相关。PDAI 评分与 FC 水平呈显著正相关（p<0.05）。 pouchitis 患者的 FC 水平中位数为 111 mg/g，明显高于无 pouchitis 患者的 16 mg/g（p<0.05）。此外，FC 水平与炎症的内镜发现呈显著正相关（p<0.00005）。
FC 水平与 PDAI 评分、血液检测数据和内镜发现相关，提示 FC 水平可作为评估 UC 患者 TP 后 pouchitis 和回肠贮袋状况的有用指标。
