Asiri Abdulaziz S, Algarni Saad S, Althubaiti Anood Q, Alzubaidi Mohammed A, Alghamdi Jamal A, Almalki Ghazi A
Internal Medicine, King Faisal Medical Complex, Taif, SAU.
Internal Medicine, Comprehensive Specialized Clinics for Security forces, Jeddah, SAU.
Cureus. 2023 Sep 11;15(9):e45019. doi: 10.7759/cureus.45019. eCollection 2023 Sep.
This review aimed to assess the diagnostic utility of fecal calprotectin (FCP) for identifying organic gastrointestinal disease (OGID) in patients undergoing colonoscopy for gastrointestinal discomfort or active progression of inflammatory bowel disease (IBD). Studies published between January 2013 and December 2022 evaluating the clinical efficacy of FCP for differentiating OGID against functional gastrointestinal disease (FGID) were identified using PubMed, Cochrane, and Scopus databases. Clinical diagnostic studies involving individuals with lower gastrointestinal symptoms; using FCP as a diagnostic biomarker either in primary, secondary, or tertiary healthcare centers conducted either prospectively or retrospectively using stool samples (index test), contrasting FCP with a reference test, such as colonoscopy, or endoscopy, and assessed using enzyme-linked immunosorbent assay were reviewed. The included studies were subjected to the revised Quality Assessment of Diagnostic Accuracy Studies for assessing the methodological quality by two independent authors. An initial literature search yielded 545 articles rendering 417 records after removing the duplicate records. After reading the abstracts and titles, 89 articles were eligible for full-text screening. The qualitative synthesis resulted in 20 articles. The efficient use of FCP for differentiating IBD from irritable bowel syndrome was investigated in 15 studies.Two of the included studies assessed the diagnostic ability of FCP to distinguish OGID from FGID, two studies utilized patients with ulcerative colitis, and one study involved patients with Crohn's disease. Overall study quality was high for 65% of studies,moderate for 25% of studies, and low for 10% of studies. The review outlined the diagnostic accuracy of non-invasive FCP assessment for OGID in various clinical scenarios and in individuals of various ages. FCP is used as a tool for screening and monitoring in clinical practice for determining the need of further comprehensive investigations, thereby reducing the redundant use of invasive techniques.
本综述旨在评估粪便钙卫蛋白（FCP）在因胃肠道不适接受结肠镜检查或炎症性肠病（IBD）病情活动进展的患者中识别器质性胃肠疾病（OGID）的诊断效用。利用PubMed、Cochrane和Scopus数据库，检索了2013年1月至2022年12月发表的评估FCP鉴别OGID与功能性胃肠疾病（FGID）临床疗效的研究。纳入了涉及下消化道症状个体的临床诊断研究；在初级、二级或三级医疗中心，以前瞻性或回顾性方式使用粪便样本（索引检测）将FCP用作诊断生物标志物，将FCP与结肠镜检查或内镜检查等参考检测进行对比，并采用酶联免疫吸附测定法进行评估。纳入的研究由两名独立作者根据修订后的《诊断准确性研究质量评估》进行方法学质量评估。初步文献检索得到545篇文章，去除重复记录后得到417条记录。阅读摘要和标题后，89篇文章符合全文筛选标准。定性综合分析得到20篇文章。15项研究探讨了FCP区分IBD和肠易激综合征的有效应用。纳入的研究中有两项评估了FCP鉴别OGID与FGID的诊断能力，两项研究纳入了溃疡性结肠炎患者，一项研究纳入了克罗恩病患者。65%的研究总体质量高，25%的研究质量中等，10%的研究质量低。本综述概述了非侵入性FCP评估在各种临床场景及不同年龄个体中对OGID诊断的准确性。FCP在临床实践中用作筛查和监测工具，以确定是否需要进一步进行全面检查，从而减少侵入性技术的过度使用。
