Does fecal calprotectin predict relapse in patients with Crohn's disease and ulcerative colitis?
Does fecal calprotectin predict relapse in patients with Crohn's disease and ulcerative colitis?
复制标题
DOI：
10.1016/j.crohns.2009.09.008
复制
发表时间：
2010-06-01
影响因子：
8
通讯作者：
Gomez-Camacho, Federico
中科院分区：
文献类型：
--
作者：
Garcia-Sanchez, Valle;Iglesias-Flores, Eva;Gomez-Camacho, Federico
背景和目标：评价粪便钙卫蛋白在预测炎症性肠病（IBD）患者复发中的效用。在克罗恩病（CD）与溃疡性结肠炎（UC），和不同的表型，其预测能力的可能差异，也examined.Methods：这是一项前瞻性研究，135例诊断为IBD的临床缓解至少3个月。患者在基线访视后24小时内提交粪便样本，用于测量粪便钙卫蛋白。结果：CD患者66例，UC患者69例。39例（30%）复发。复发患者的粪便钙卫蛋白浓度高于保持缓解的患者：444 μ g/g（95% CI 34-983）vs. 112 μ g/g（95% CI 22-996）; p << 0.01. Patients with CD and calprotectin >200 μ g/g的患者复发率是标记物浓度较低患者的4倍。在UC中，钙卫蛋白> 120 μ g/g与疾病活动爆发概率增加6倍相关。UC和CD伴结肠受累和炎症模式的预测值相似。在该组中，钙卫蛋白> 120 μ g/g预测复发风险的敏感性为80%，特异性为60%。复发预测能力较低的患者回肠diseases.Conclusions：粪便钙卫蛋白可能是一个有用的标志物预测复发的IBD患者。与回肠CD相比，其对UC和CD伴结肠受累和炎症模式的预测价值更高。(C)2009年欧洲克罗恩病和结肠炎组织。Elsevier B. V.出版，保留所有权利。
Background and aims: An evaluation is made of the utility of fecal calprotectin in predicting relapse in patients with inflammatory bowel disease (IBD). The possible differences in its predictive capacity in Crohn's disease (CD) versus ulcerative colitis (UC), and the different phenotypes, are also examined.Methods: This is a prospective study with 135 patients diagnosed with IBD in clinical remission for at least 3 months. The patients submitted a stool sample within 24 hours after the baseline visit, for the measurement of fecal calprotectin. All patients were followed-up on for one year.Results: Sixty-six patients had CD and 69 UC. Thirty-nine (30%) suffered from relapse. The fecal calprotectin concentration was higher among the patients with relapse than in those that remained in remission: 444 mu g/g (95% CI 34-983) versus 112 mu g/g (95% CI 22-996); p < 0.01. Patients with CD and calprotectin > 200 mu g/g relapsed 4 times more often than those with lower marker concentrations. In UC, calprotectin > 120 mu g/g was associated with a 6-fold increase in the probability of disease activity outbreak. The predictive value was similar in UC and CD with colon involvement and inflammatory pattern. In this group, calprotectin > 120 mu g/g predicted relapse risk with a sensitivity of 80% and a specificity of 60%. Relapse predictive capacity was lower in patients with ileal disease.Conclusions: Fecal calprotectin may be a useful marker for predicting relapse in patients with IBD. Its predictive value is greater in UC and CD with colon involvement and inflammatory pattern, compared with ileal CD. (C) 2009 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.