粪便钙卫蛋白、乳铁蛋白及其他粪便生物标志物在鉴别克罗恩病内镜活动度中的应用：一项系统评价和荟萃分析
The Utility of Faecal Calprotectin, Lactoferrin and Other Faecal Biomarkers in Discriminating Endoscopic Activity in Crohn's Disease: A Systematic Review and Meta-Analysis.
作者信息
Bohra Anuj, Mohamed Ghada, Vasudevan Abhinav, Lewis Diana, Van Langenberg Daniel R, Segal Jonathan P
机构信息
Department of Gastroenterology, Eastern Health, Box Hill, Melbourne, VIC 3128, Australia.
Department of Gastroenterology, Northern Health, Epping, Melbourne, VIC 3076, Australia.
出版信息
Biomedicines. 2023 May 9;11(5):1408. doi: 10.3390/biomedicines11051408.
INTRODUCTION
Currently, faecal calprotectin (FC) is the predominate faecal biomarker utilised in clinical practice to monitor Crohn's disease (CD) activity. However, there are several potential faecal biomarkers described in the literature. We performed a meta-analysis to determine the accuracy of faecal biomarkers in discriminating endoscopic activity and mucosal healing in CD.
METHODS
We searched the medical literature using MEDLINE, EMBASE, and PubMed from 1978 to 8 August 2022. Descriptive statistics, including sensitivity, specificity of the primary studies, their positive and negative likelihood ratios, and their diagnostic odds ratio (DOR), were calculated. The methodological quality of the included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS) criteria.
RESULTS
The search found 2382 studies, of which 33 were included for analysis after screening. FC was found to have a pooled sensitivity and specificity, DOR, and negative predictive value (NPV) in discriminating active endoscopic disease (versus inactive) of 81%, 74%, 13.93, and 0.27, respectively. Faecal lactoferrin (FL) had a pooled sensitivity and specificity, DOR, and NPV in discriminating active endoscopic disease of 75%, 80%, 13.41, and 0.34, respectively. FC demonstrated a pooled sensitivity and specificity, DOR, and NPV of 88%, 72%, 18.17, and 0.19 in predicting mucosal healing.
CONCLUSION
FC remains an accurate faecal biomarker. Further evaluation of the utility of novel faecal biomarkers is needed.
引言
目前，粪便钙卫蛋白（FC）是临床实践中用于监测克罗恩病（CD）活动的主要粪便生物标志物。然而，文献中描述了几种潜在的粪便生物标志物。我们进行了一项荟萃分析，以确定粪便生物标志物在鉴别CD内镜活动和黏膜愈合方面的准确性。
方法
我们使用MEDLINE、EMBASE和PubMed检索了1978年至2022年8月8日的医学文献。计算了描述性统计数据，包括主要研究的敏感性、特异性、阳性和阴性似然比以及诊断比值比（DOR）。使用诊断准确性研究质量评估-2（QUADAS）标准评估纳入研究的方法学质量。
结果
检索到2382项研究，其中33项在筛选后纳入分析。发现FC在鉴别活动性内镜疾病（与非活动性相比）时的合并敏感性、特异性、DOR和阴性预测值（NPV）分别为81%、74%、13.93和0.27。粪便乳铁蛋白（FL）在鉴别活动性内镜疾病时的合并敏感性、特异性、DOR和NPV分别为75%、80%、13.41和0.34。FC在预测黏膜愈合方面的合并敏感性、特异性、DOR和NPV分别为88%、72%、18.17和0.19。
结论
FC仍然是一种准确的粪便生物标志物。需要进一步评估新型粪便生物标志物的效用。
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