Faecal calprotectin as reliable non-invasive marker to assess the severity of mucosal inflammation in children with inflammatory bowel disease
Faecal calprotectin as reliable non-invasive marker to assess the severity of mucosal inflammation in children with inflammatory bowel disease
复制标题
DOI：
10.1016/j.dld.2008.01.017
复制
发表时间：
2008-07-01
影响因子：
4.5
通讯作者：
Troncone, R.
中科院分区：
文献类型：
--
作者：
Canani, R. Berni;Terrin, G.;Troncone, R.
背景准确监测粘膜炎症对于炎症性肠病患者的有效管理非常重要。肠道炎症可以通过粪便钙卫蛋白水平测定来检测。比较粪钙卫蛋白、临床评分、常见血清标志物及内镜检查对炎症性肠病患儿肠黏膜炎症程度评估的准确性。入组了58例确诊为炎症性肠病（26例克罗恩病，32例溃疡性结肠炎）的儿科患者（平均年龄13.9岁，95% CI 2.9-14.8;男性28例）。内镜检查前，所有患者均接受了完整的评估，包括：临床评分，红细胞沉降率，C反应蛋白和粪便钙卫蛋白测定。使用特定的内镜和组织学评分评估粘膜炎症的严重程度。粪便钙卫蛋白显示出高度的相关性（r = 0.655）与粘膜炎症的组织学分级相似，与内窥镜观察结果相似（r = 0.699），结果表明，该方法是最准确的工具（敏感性94%，特异性64%，阳性预测值81%，阴性预测值87%）检测活动性粘膜炎症的存在。在临床和实验室明显缓解的患者中，粪便钙卫蛋白的准确性进一步提高（敏感性100%，特异性80%，阳性预测值67%，阴性预测值100%）。与其他常见的临床和实验室指标相比，通过测定粪便钙卫蛋白水平可以更准确地评估粘膜炎症的严重程度。这种非侵入性和客观的方法可能是特别有用的患者有明显的临床和实验室缓解。(c)2008年意大利胃肠病学编辑由爱思唯尔有限公司出版。保留所有权利。
Background. An accurate monitoring of mucosal inflammation is important for an effective management of patients with inflammatory bowel disease. Intestinal inflammation can be detected by faecal calprotectin level determination.Aim. To comparatively evaluate the accuracy of faecal calprotectin, clinical scores, common serum markers and endoscopy in the assessment of the severity of intestinal mucosa inflammation in children with inflammatory bowel disease.Methods. Fifty-eight paediatric patients (mean age 13.9 years, 95% CI 2.9-14.8; male 28) with confirmed inflammatory bowel disease (26 Crohn's disease, 32 ulcerative colitis) were enrolled. Before endoscopy, all patients underwent a complete evaluation including: clinical scores, erythrocyte sedimentation rate, C-reactive protein and faecal calprotectin determination. The severity of mucosal inflammation was assessed using specific endoscopic and histologic scores.Results. Faecal calprotectin showed a high correlation (r = 0.655) with the histologic grade of mucosal inflammation, similar to that observed for endoscopy (r = 0.699), and it resulted the most accurate tool (sensitivity 94%, specificity 64%, positive predictive value 81%, negative predictive value 87%) to detect the presence of active mucosal inflammation when compared to clinical scores and common serum markers. In patients with apparent clinical and laboratory remission the accuracy of faecal calprotectin resulted further improved (sensitivity 100%, specificity 80%, positive predictive value 67%, negative predictive value 100%).Conclusions. A more accurate assessment of the severity of mucosal inflammation can be achieved by the determination of faecal calprotectin levels compared to other common clinical and laboratory indices. This non-invasive and objective method could be particular useful in patients with apparent clinical and laboratory remission. (c) 2008 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.