Fecal calprotectin as a non-invasive biomarker for intestinal involvement of Behcet's disease
Fecal calprotectin as a non-invasive biomarker for intestinal involvement of Behcet's disease
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DOI：
10.1111/jgh.13530
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发表时间：
2017-03-01
影响因子：
4.1
通讯作者：
Cheon, Jae Hee
中科院分区：
文献类型：
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作者：
Kim, Duk Hwan;Park, Yehyun;Cheon, Jae Hee
背景与目的：粪便钙保护蛋白（FC）水平在炎症性肠病患者中的诊断和预后价值已被证实。然而，FC测量在预测白塞氏病（BD）肠受累方面的有用性知之甚少。方法：前瞻性纳入2012年11月至2014年3月在单一三级医疗中心连续44例接受结肠镜检查以评估胃肠道症状的系统性BD患者。患者于清肠前一天及结肠镜检查后3个月采集粪便标本。结果：25例患者结肠镜检查发现肠道溃疡，其中典型溃疡12例（48.0%），不典型溃疡13例（52.0%）。肠道BD组中位FC水平显著高于非诊断组（分别为112.53[6.86-1604.39]和31.64 [5.46-347.60]mu g/g, P = 0.003）。肠道BD患者典型溃疡组中位FC水平显著高于非典型溃疡组（435.995 [75.65- 164.39]vs 71.42 [6.86-476.94] mu g/g, P = 0.033）。多因素分析显示，较高的FC是肠道BD的独立预测因子（OR = 38.776; 95% CI = 2.306-652.021; P = 0.011）。预测肠道BD的FC截止水平为68.89 μ g/g（76%的敏感性和79%的特异性）。粪便钙保护蛋白水平与肠道BD疾病活动性指数自诊断至诊断后3个月的绝对变化呈显著相关（Pearson相关系数= 0.470,P = 0.027）。结论：FC水平可作为BD累及肠道的无创替代标志物。
Background and Aim: The diagnostic and prognostic values of fecal calprotectin (FC) levels in patients with inflammatory bowel diseases have been proven. However, little is known about the usefulness of FC measurement in predicting intestinal involvement of Behcet's disease (BD).Methods: Forty-four consecutive patients with systemic BD who underwent colonoscopy for the evaluation of gastrointestinal symptoms were prospectively enrolled between November 2012 and March 2014 in a single tertiary medical center. Fecal specimens from the patients were obtained the day before bowel cleansing and 3 months after colonoscopy.Results: Twenty-five patients showed intestinal ulcerations on colonoscopy (12 [48.0%] typical and 13 [52.0%] atypical ulcerations). The median FC level in the intestinal BD group was significantly higher than that in the non-diagnostic group (112.53 [6.86-1604.39] vs 31.64 [5.46-347.60] mu g/g, respectively, P = 0.003). Moreover, the typical ulceration group showed a significantly higher median FC level than the atypical ulceration group in patients with intestinal BD (435.995 [75.65-1604.39] vs 71.42 [6.86-476.94] mu g/g, respectively, P = 0.033). Multivariate analysis revealed higher FC as an independent predictor of intestinal BD (OR = 38.776; 95% CI = 2.306-652.021; P = 0.011). The cut-off level of FC for predicting intestinal BD was 68.89 mu g/g (76% sensitivity and 79% specificity). The absolute changes between fecal calprotectin levels and the disease activity index of intestinal BD from initial diagnosis of intestinal BD to 3 months after diagnosis were significantly correlated (Pearson's correlation coefficient = 0.470, P = 0.027).Conclusion: The FC level might serve as a non-invasive surrogate marker of intestinal involvement of BD.