Department of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
Pediatr Surg Int. 2023 Aug 18;39(1):250. doi: 10.1007/s00383-023-05534-7.
This study aimed to evaluate the clinical utility of fecal calprotectin (FC) levels during the necrotizing enterocolitis (NEC) episode to predict the onset of post-NEC intestinal stricture.
The medical records of patients with NEC treated from April 2020 to April 2022 were recorded for this study. FC was quantified at the acute phase of NEC. FC levels were compared in patients with or without intestinal stricture. Receiver operating characteristics (ROC) analysis was constructed to determine optimal cut-offs of FC for post-NEC intestinal stricture.
A total of 50 infants with NEC were enrolled in this study and 14 (28%) of them eventually developed intestinal stricture. All children with intestinal stricture underwent one-stage surgery and all made it through the follow-up period alive. The median FC level was 1237.55 (741.25, 1378.80) ug/g in patients with intestinal stricture and it was significantly higher than that in the non-stricture group [158.30 (76.23, 349.13) ug/g, P < 0.001]. FC had good diagnostic accuracy for predicting intestinal stricture, according to ROC curve analysis, with an AUC area of 0.911. At an optimal cut-off value of 664.2 ug/g, sensitivity and specificity were 85.71% and 91.67%, respectively.
As a non-invasive parameter, FC has excellent efficacy and accuracy in predicting post-NEC intestinal stricture. Increased FC levels at the acute phase of NEC were associated with the development of intestinal stricture.
本研究旨在评估坏死性小肠结肠炎（NEC）发作期间粪便钙卫蛋白（FC）水平的临床实用性，以预测 NEC 后肠狭窄的发生。
本研究记录了 2020 年 4 月至 2022 年 4 月期间治疗的 NEC 患者的病历。在 NEC 的急性期定量测定 FC。比较有或无肠狭窄的患者的 FC 水平。构建受试者工作特征（ROC）曲线分析以确定 FC 预测 NEC 后肠狭窄的最佳截断值。
本研究共纳入 50 例 NEC 婴儿，其中 14 例（28%）最终发生肠狭窄。所有肠狭窄患儿均行一期手术，均顺利通过随访期存活。肠狭窄组患儿 FC 中位数为 1237.55（741.25，1378.80）ug/g，明显高于非狭窄组[158.30（76.23，349.13）ug/g，P<0.001]。ROC 曲线分析显示，FC 对预测肠狭窄具有良好的诊断准确性，AUC 面积为 0.911。在最佳截断值 664.2 ug/g 时，敏感性和特异性分别为 85.71%和 91.67%。
作为一种非侵入性参数，FC 在预测 NEC 后肠狭窄方面具有良好的疗效和准确性。NEC 急性期 FC 水平升高与肠狭窄的发生有关。
