粪便钙卫蛋白在预测已知克罗恩病的儿科患者小肠胶囊内镜检查结果中的作用。

Fecal calprotectin in predicting small bowel capsule endoscopy findings in pediatric patients with known Crohn's disease.

机构信息

Department of Gastroenterology in Children's hospital of Fudan University, Shanghai, China.

出版信息

Medicine (Baltimore). 2022 Oct 21;101(42):e31163. doi: 10.1097/MD.0000000000031163.

Abstract

Fecal calprotectin (FC) has been proposed as a noninvasive surrogate marker of intestinal inflammation in inflammatory bowel disease. This study aimed to assess the capability of FC in predicting small bowel capsule endoscopy (SBCE) findings in pediatric patients with known Crohn's disease (CD). We retrieved data of consecutive patients aged 2 to 17 years old with established CD who underwent SBCE from Janurary 2017 to April 2020 and had endoscopic remission on ileocolonoscopy. Sixty-eight patients were included in the analysis. There were 13 patients with a weighted pediatric CD activity index ≥ 12.5, 47 patients with FC ≥ 200 µg/g, and 45 patients with significant small bowel (SB) inflammation [Lewis score (LS) ≥ 135]. The LS correlated weakly with FC (R = 0.30, P < .05). The area under the curve of FC as a surrogate diagnostic test for LS ≥ 135 was 0.691, and the optimal FC cutoff values were 242 µg/g with the corresponding sensitivity and specificity of 78% and 65%, respectively. The area under the curve of FC for moderate-to-severe inflammatory activity in the SB was 0.718. In patients with FC level ≥ 670 µg/g, LS ≥ 790 was found in 33% (9/27) of patients, with the sensitivity and specificity of 69% and 67%, respectively. FC may be used to predict SB mucosal inflammation in pediatric patients with confirmed CD having endoscopic remission on ileocolonoscopy.

摘要

粪便钙卫蛋白(FC)已被提议作为炎症性肠病(IBD)中肠道炎症的非侵入性替代标志物。本研究旨在评估 FC 在预测已知克罗恩病(CD)的儿科患者的小肠胶囊内镜(SBCE)结果方面的能力。我们检索了 2017 年 1 月至 2020 年 4 月期间接受 SBCE 检查且结肠镜下回结肠缓解的连续年龄在 2 至 17 岁的 CD 患者的数据。68 例患者纳入分析。其中 13 例患儿的加权儿科 CD 活动指数≥12.5,47 例 FC≥200µg/g,45 例存在显著的小肠(SB)炎症[Lewis 评分(LS)≥135]。LS 与 FC 呈弱相关(R=0.30,P<0.05)。FC 作为 LS≥135 的替代诊断试验的曲线下面积为 0.691,最佳 FC 截断值为 242µg/g,相应的敏感性和特异性分别为 78%和 65%。FC 对 SB 中度至重度炎症活动的曲线下面积为 0.718。在 FC 水平≥670µg/g 的患者中,27 例患者中有 33%(9/27)的 LS≥790,其敏感性和特异性分别为 69%和 67%。FC 可用于预测结肠镜下回结肠缓解的确诊 CD 儿科患者的 SB 黏膜炎症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1682/9592269/caff01c8bfdb/medi-101-e31163-g001.jpg

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