粪便钙卫蛋白检测作为乳糜泻和非乳糜泻性肠病严重疾病表型的生物标志物。
Fecal calprotectin measurement as a biomarker of severe disease phenotype in celiac disease and non-celiac enteropathies.
作者信息
Schiepatti Annalisa, Cappellini Alessandro, Maimaris Stiliano, Minerba Paolo, Retrosi Martina, Mantica Giulia, Scarcella Chiara, Delogu Claudia, Arpa Giovanni, Bianchi Paola Ilaria, Di Sabatino Antonio, Biagi Federico
机构信息
Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Gastroenterology Unit of Pavia Institute, Pavia, Italy.
Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
出版信息
Dig Liver Dis. 2025 Jan;57(1):308-314. doi: 10.1016/j.dld.2024.09.010. Epub 2024 Oct 5.
BACKGROUND
Fecal calprotectin (FC) is a non-invasive biomarker of gut inflammation, but its role in celiac disease (CD) and non-celiac enteropathies (NCEs) is undefined.
AIMS
To retrospectively evaluate FC in patients with CD and NCEs as a tool for assessing disease activity and predicting long-term outcomes.
METHODS
Patients with uncomplicated and complicated CD, and NCEs with data on FC, evaluated at our center between June-2008 and December-2023, were enrolled. The relationship between elevated FC (>50 mg/kg) and disease activity was statistically analysed and Cox regression adjusted for age and sex was used to compare development of complications and mortality in patients with elevated and normal FC.
RESULTS
177 patients (109F, mean age at diagnosis 39±20 years, 132 CD, 17 complicated CD, 28 NCEs) were enrolled. 55 patients had elevated FC, which was associated with lack of clinical and histological response to therapy (both p < 0.001). During a median follow-up of 103 months (IQR 54-176), 22 patients developed complications (15.4 %) and 21 died (11.9 %). Elevated FC was significantly more common in complicated CD (70.6 %) and NCEs (67.9 %) than in uncomplicated CD (18.2 %), p < 0.001. Elevated FC was independently predictive of developing complications (HR 4.8,95 %CI 1.4-17.7, p = 0.01) and mortality (HR 4.8,95 %CI 1.6-14.3, p < 0.01).
CONCLUSION
FC is a promising non-invasive biomarker for assessing disease severity and long-term outcomes in CD and NCEs.
背景
粪便钙卫蛋白（FC）是肠道炎症的一种非侵入性生物标志物，但其在乳糜泻（CD）和非乳糜泻性肠病（NCEs）中的作用尚不清楚。
目的
回顾性评估CD和NCEs患者的FC，作为评估疾病活动度和预测长期结局的工具。
方法
纳入2008年6月至2023年12月在本中心评估的无并发症和有并发症的CD患者以及有FC数据的NCEs患者。对FC升高（>50mg/kg）与疾病活动度之间的关系进行统计学分析，并采用经年龄和性别调整的Cox回归比较FC升高和正常的患者发生并发症和死亡的情况。
结果
共纳入177例患者（109例女性，诊断时平均年龄39±20岁，132例CD，17例复杂性CD，28例NCEs）。55例患者FC升高，这与治疗的临床和组织学反应缺乏相关（均p<0.001）。在中位随访103个月（四分位间距54-176）期间，22例患者发生并发症（15.4%），21例死亡（11.9%）。FC升高在复杂性CD（70.6%）和NCEs（67.9%）中比在无并发症CD（18.2%）中显著更常见，p<0.001。FC升高独立预测发生并发症（HR 4.8，95%CI 1.4-17.7，p=0.01）和死亡（HR 4.8，95%CI 1.6-14.3，p<0.01）。
结论
FC是评估CD和NCEs疾病严重程度和长期结局的一种有前景的非侵入性生物标志物。
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