Kim Hae Ryung, Kim Youie, Moon Jin Soo, Ko Jae Sung, Yang Hye Ran
Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Pediatrics, Incheon St. Mary's Hospital, Incheon, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2024 Mar;27(2):79-87. doi: 10.5223/pghn.2024.27.2.79. Epub 2024 Mar 4.
Recently, the prevalence of eosinophilic gastrointestinal disease (EGID) has shown an increasing trend worldwide. As the diagnosis of EGID requires invasive endoscopy with biopsy, noninvasive markers for detecting EGID in suspected patients, particularly children, are urgently needed. Therefore, this study aimed to evaluate the diagnostic accuracy of serum eosinophil cationic protein (ECP) beyond peripheral eosinophil counts in pediatric patients with EGID.
Overall, 156 children diagnosed with EGID were enrolled and 150 children with functional abdominal pain disorder (FAPD) were recruited as controls. All participants underwent endoscopic biopsy in each segment of the gastrointestinal (GI) tract and serum ECP measurement, as well as peripheral eosinophil percent and absolute eosinophil count.
Comparing EGID (n=156) with FAPD (n=150) patients, serum ECP levels were significantly higher in pediatric patients with EGID than in those with FAPD (25.8±28.6 µg/L vs. 19.5±21.0 µg/L, =0.007), while there was no significant difference in peripheral eosinophil percent and absolute eosinophil counts between the two groups. Serum ECP levels were correlated with peripheral eosinophil percent (r=0.593, <0.001) and the absolute eosinophil count (r=0.660, <0.001). The optimal cutoff value of serum ECP for pediatric EGID was 10.5 µg/mL, with a sensitivity of 69.9% and a specificity of 43.4% with an area under the receiver operating characteristic curve of 0.562.
The combination of serum ECP levels and peripheral eosinophil counts, when employed with appropriated thresholds, could serve as a valuable noninvasive biomarker to distinguish between EGID and FAPD in pediatric patients manifesting GI symptoms.
近年来，嗜酸性粒细胞性胃肠道疾病（EGID）在全球范围内的患病率呈上升趋势。由于EGID的诊断需要通过侵入性内镜检查及活检，因此迫切需要用于检测疑似患者（尤其是儿童）EGID的非侵入性标志物。因此，本研究旨在评估血清嗜酸性粒细胞阳离子蛋白（ECP）在儿科EGID患者中相对于外周血嗜酸性粒细胞计数的诊断准确性。
总共纳入了156名诊断为EGID的儿童，并招募了150名功能性腹痛障碍（FAPD）儿童作为对照。所有参与者均接受了胃肠道各段的内镜活检、血清ECP检测，以及外周血嗜酸性粒细胞百分比和嗜酸性粒细胞绝对计数检测。
将EGID患者（n = 156）与FAPD患者（n = 150）进行比较，儿科EGID患者的血清ECP水平显著高于FAPD患者（25.8±28.6μg/L对19.5±21.0μg/L，P = 0.007），而两组之间外周血嗜酸性粒细胞百分比和嗜酸性粒细胞绝对计数无显著差异。血清ECP水平与外周血嗜酸性粒细胞百分比（r = 0.593，P < 0.001）和嗜酸性粒细胞绝对计数（r = 0.660，P < 0.001）相关。儿科EGID血清ECP的最佳截断值为10.5μg/mL，灵敏度为69.9%，特异性为43.4%，受试者工作特征曲线下面积为0.562。
血清ECP水平与外周血嗜酸性粒细胞计数相结合，并采用适当的阈值，可作为区分表现出胃肠道症状的儿科患者EGID和FAPD的有价值的非侵入性生物标志物。
