Jain Ankit V, Gopal Sandeep, Shetty Anurag J, Shenoy Suresh, Tantry B V, Unnikrishnan B, Holla Ramesh, Anand Rishit
Department of Medical Gastroenterology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576 104, India.
Department of Community Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
BMC Gastroenterol. 2025 Jun 4;25(1):429. doi: 10.1186/s12876-025-04035-2.
Inflammatory bowel disease (IBD) is an idiopathic disorder characterized by repeated relapses and remissions. Endoscopy, the gold standard for diagnosis and monitoring of these patients is time consuming, expensive, and invasive. Hence, faecal calprotectin (FCP) has been suggested as marker to determine the degree of intestinal inflammation and predict relapse in IBD.
To use FCP as a predictor of clinical activity and endoscopic severity in IBD patients in a tertiary care hospital in Southern India.
Study subjects underwent clinical examination, endoscopy, blood tests and stool FCP. For Endoscopic activity simple endoscopic score for Crohn's disease (SES-CD) and Ulcerative Colitis endoscopic index of severity (UCEIS) scores were used, and clinical activity was assessed by Crohn's disease activity index (CDAI) and simple clinical colitis index (SCCAI) for CD and UC respectively. At six months, blood, and stool FCP test were repeated which were compared with endoscopic and clinical activity indices.
The number of males was higher in both CD (13/8) and UC (19/14). At first visit and follow up, CDAI and FCP were positively correlated (r-0.689, p- 0.016) (r- 0.425, p-value < 0.05). In CD, the sensitivity and specificity of FCP in detecting active disease and remission were 93.8% and 80% respectively (AUC-0.869). At follow up, the sensitivity and specificity were 80% and 93.3% respectively (AUC-0.867). In patients with UC, SCCAI score and FCP levels positively correlated (r-0.231/0.387, p-value 0.001/0.001) at both the first and follow up visits. The sensitivity of FCP in detecting UC in active and remission states was 92.6% whereas the specificity was 83.3%. AUC was 0.88. At the time of follow up, the sensitivity of FCP in detecting UC in active and remission states was 89.9% whereas the specificity was 87.0% and AUC was 0.879.
This study confirmed that FCP level shows strong association with clinical and endoscopic activity indices in patients of IBD. Therefore, FCP levels could be used as a surrogate marker for monitoring mucosal status as well as predicting endoscopic remission in IBD patients.
炎症性肠病（IBD）是一种以反复复发和缓解为特征的特发性疾病。内镜检查作为这些患者诊断和监测的金标准，耗时、昂贵且具有侵入性。因此，粪便钙卫蛋白（FCP）已被建议作为确定肠道炎症程度和预测IBD复发的标志物。
在印度南部一家三级医院中，将FCP用作IBD患者临床活动和内镜严重程度的预测指标。
研究对象接受临床检查、内镜检查、血液检测和粪便FCP检测。对于内镜活动度，采用克罗恩病简单内镜评分（SES-CD）和溃疡性结肠炎内镜严重程度指数（UCEIS）评分，对于克罗恩病（CD）和溃疡性结肠炎（UC），分别通过克罗恩病活动指数（CDAI）和简单临床结肠炎指数（SCCAI）评估临床活动度。在六个月时，重复进行血液和粪便FCP检测，并与内镜和临床活动指标进行比较。
CD组（13/8）和UC组（19/14）中男性人数均较多。在首次就诊和随访时，CDAI与FCP呈正相关（r = 0.689，p = 0.016）（r = 0.425，p值<0.05）。在CD中，FCP检测活动性疾病和缓解的敏感性和特异性分别为93.8%和80%（AUC = 0.869）。随访时，敏感性和特异性分别为80%和93.3%（AUC = 0.867）。在UC患者中，首次就诊和随访时SCCAI评分与FCP水平均呈正相关（r = 0.231/0.387，p值= 0.001/0.001）。FCP检测UC活动期和缓解期的敏感性为92.6%，特异性为83.3%。AUC为0.88。随访时，FCP检测UC活动期和缓解期的敏感性为89.9%，特异性为87.0%，AUC为0.879。
本研究证实，FCP水平与IBD患者的临床和内镜活动指标密切相关。因此，FCP水平可作为监测IBD患者黏膜状态以及预测内镜缓解的替代标志物。
