Low Fecal Calprotectin Predicts Histological Healing in Patients with Ulcerative Colitis with Endoscopic Remission and Leads to Prolonged Clinical Remission
Low Fecal Calprotectin Predicts Histological Healing in Patients with Ulcerative Colitis with Endoscopic Remission and Leads to Prolonged Clinical Remission
复制标题
DOI：
10.1093/ibd/izac095
复制
发表时间：
2022-05-18
影响因子：
4.9
通讯作者：
Ishihara, Shunji
中科院分区：
文献类型：
--
作者：
Kawashima, Kousaku;Oshima, Naoki;Ishihara, Shunji
背景 关于粪便钙卫蛋白（FC）预测溃疡性结肠炎（UC）组织学愈合（HH）的截止值缺乏共识。本研究旨在确定预测临床和内镜缓解的 UC 患者 HH 的最佳 FC 截止值。此外，还研究了 FC 对延长临床缓解 (CR) 的可预测性。方法 临床和内镜缓解的 UC 患者，定义为部分 Mayo 评分 (PMS) 2 或药物升级。结果 76 名 UC 患者纳入其中。 HH 患者 (n = 40) 的中位 FC 值为 56.2 μg/g，显着低于有组织学活动的患者 (118.1 μg/g；P < .01)。用于预测 FC HH 的受试者工作特征 (ROC) 曲线分析中的曲线下面积 (AUC) 为 0.71（95% 置信区间 [CI]，0.59-0.83），最佳截止值为 82.7 μg/g（73% 敏感性；64% 特异性；P < .01）。在观察 2 年的 74 名患者中，54 名 (73%) 的 CR 延长。在 ROC 曲线分析中，预测 FC 延长 CR 的 AUC 为 0.79（95% CI，0.68-0.90），相当于 HH 的 AUC（0.73；95% CI，0.64-0.86；P = 0.40）。预测长期 CR 的最佳 FC 截止值为 84.6 μg/g（72% 敏感性；85% 特异性；P < .01）。结论 粪便钙卫蛋白 < 82 μg/g 可以预测临床和内镜缓解的 UC 患者出现 HH。低 FC 导致 CR 延长，相当于 HH.Lay 总结 粪便钙卫蛋白 (FC) 水平 < 82 μg/g 可预测溃疡性结肠炎患者的组织学愈合，并获得临床和内镜缓解。对于临床和内镜缓解的患者来说，低 FC 可以延长临床缓解长达 2 年，相当于组织学愈合。
Background Consensus regarding the cutoff value of fecal calprotectin (FC) for predicting histological healing (HH) in ulcerative colitis (UC) is lacking. This study aimed to determine an optimal FC cutoff value for predicting HH in patients with UC with clinical and endoscopic remission. Furthermore, FC's predictability for prolonged clinical remission (CR) was investigated. Methods Patients with UC in clinical and endoscopic remission, defined as a partial Mayo score (PMS) 2 or medication escalation. Results Seventy-six patients with UC were included. The median FC value in patients with HH (n = 40) was 56.2 mu g/g, significantly lower than that in those with histological activity (118.1 mu g/g; P < .01). The area under the curve (AUC) in a receiver operating characteristic (ROC) curve analysis to predict HH for FC was 0.71 (95% confidence interval [CI], 0.59-0.83), with an optimal cutoff value of 82.7 mu g/g (73% sensitivity; 64% specificity; P < .01). Of 74 patients observed for 2 years, 54 (73%) had prolonged CR. In the ROC curve analysis, the AUC to predict prolonged CR for FC was 0.79 (95% CI, 0.68-0.90), equivalent to that for HH (0.73; 95% CI, 0.64-0.86; P = .40). The optimal FC cutoff value to predict prolonged CR was 84.6 mu g/g (72% sensitivity; 85% specificity; P < .01). Conclusions Fecal calprotectin < 82 mu g/g predicts HH in patients with UC with clinical and endoscopic remission. Low FC leads to prolonged CR, equivalent to HH.Lay Summary Fecal calprotectin (FC) levels < 82 mu g/g predict histological healing in ulcerative colitis patients with clinical and endoscopic remission. Low FC leads to prolonged clinical remission for up to 2 years in those with clinical and endoscopic remission, equivalent to histological healing.