Jin Shengnan, Zhang Maozhen, Gu Dongdong, Zhu Xingping, Wang Zuolei, Shi Xuerong, Hao Yanping, Xu Su
Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China.
Department of Blood transfusion, Yancheng No. 1 People's Hospital, Yancheng, China.
J Int Med Res. 2025 Apr;53(4):3000605251328245. doi: 10.1177/03000605251328245. Epub 2025 Apr 11.
ObjectivesThis study aimed to identify risk factors for postoperative recurrence in patients with perianal fistulizing Crohn's disease and assess the predictive value of fecal calprotectin and serum miRNA6086.MethodsFrom 105 patients with perianal fistulizing Crohn's disease, blood and fecal samples as well as clinical data were collected. Analysis of blood tests, C-reactive protein, miRNA6086, and fecal calprotectin revealed postoperative recurrence risk factors. Receiver operating characteristic curve analysis assessed the predictive accuracy of miRNA6086 and fecal calprotectin for perianal fistulizing Crohn's disease recurrence and determined their optimal cutoff values, sensitivity, and specificity.ResultsOf the 105 patients with perianal fistulizing Crohn's disease, 33 (31.4%) experienced recurrence. Anal fistula type, preoperative miRNA6086, and fecal calprotectin levels were identified as independent risk factors for postoperative recurrence. Receiver operating characteristic curve analysis revealed that miRNA6086 had a cutoff value of 0.3195, sensitivity of 65.28%, specificity of 66.67%, and area under curve value of 0.6589 (95% confidence interval, 0.5503-0.7674). Fecal calprotectin had a cutoff value of 0.6073, sensitivity of 81.94%, specificity of 78.79%, and area under curve value of 0.8224 (95% confidence interval, 0.5503-0.7674). Combined miRNA6086 and fecal calprotectin detection had a cutoff value of 0.7121, sensitivity of 83.33%, specificity of 87.88%, and area under curve value of 0.9146 (95% confidence interval, 0.8547-0.9744).ConclusionAnal fistula type, preoperative miRNA6086, and fecal calprotectin levels are independent risk factors for perianal fistulizing Crohn's disease recurrence. Combined detection of miRNA6086 and fecal calprotectin levels enhances predictive accuracy for postoperative recurrence.
目的
本研究旨在确定肛周瘘管型克罗恩病患者术后复发的危险因素，并评估粪便钙卫蛋白和血清miRNA6086的预测价值。
方法
收集105例肛周瘘管型克罗恩病患者的血液、粪便样本及临床资料。通过对血液检查、C反应蛋白、miRNA6086和粪便钙卫蛋白的分析揭示术后复发的危险因素。采用受试者工作特征曲线分析评估miRNA6086和粪便钙卫蛋白对肛周瘘管型克罗恩病复发的预测准确性，并确定其最佳临界值、敏感性和特异性。
结果
105例肛周瘘管型克罗恩病患者中，33例（31.4%）复发。肛瘘类型、术前miRNA6086和粪便钙卫蛋白水平被确定为术后复发的独立危险因素。受试者工作特征曲线分析显示，miRNA6086的临界值为0.3195，敏感性为65.28%，特异性为66.67%，曲线下面积值为0.6589（95%置信区间，0.5503 - 0.7674）。粪便钙卫蛋白的临界值为0.6073，敏感性为81.94%，特异性为78.79%，曲线下面积值为0.8224（95%置信区间，0.5503 - 0.7674）。联合检测miRNA6086和粪便钙卫蛋白的临界值为0.7121，敏感性为83.33%，特异性为87.88%，曲线下面积值为0.9146（95%置信区间，0.8547 - 0.9744）。
结论
肛瘘类型、术前miRNA6086和粪便钙卫蛋白水平是肛周瘘管型克罗恩病复发的独立危险因素。联合检测miRNA6086和粪便钙卫蛋白水平可提高术后复发的预测准确性。
