The value of fecal calprotectin in predicting endoscopic activity and severity of ulcerative colitis / 医学研究生学报

ABSTRACT

Objective The invasive colonoscopy is an important method for evaluating the severity of intestine and the muco-sal healing in ulcerative colitis(UC)patients. The aim of this study was to investigate the advantage of fecal calprotectin(FC)in diagnosing UC endoscopic activity and severity and analyze the FC correlation with endoscopic scores. Methods A total of 70 UC in-patients in our hospital from January 2016 to September 2017 were retrospectively analyzed and categorized into endoscopic remission UC [mucosal healing(n=12),mucosal lesion(n=10)]and endoscopic active UC[mild-moderate(n=30)and severe(n=18)]according to UC Endoscopic Index of Severity(UCEIS).The ROC curve was used to analyze the predictive efficacy of each laboratory indicator to identify endoscopically active UC and severe UC and evaluate the correlation of UCEIS with all these indicators. Results In UC pa-tients,the levels of FC[828.5(416.6,1079.7)μg/g],PCT[0.03(0.02,0.06)μg/L]and IL-6[13.4(7.32,21.45)ng/L]were sig-nificantly higher in endoscopically active UC than those[43.4(9.4,91.4)μg/g、0.02(0.02,0.03)μg/L、5.82(5.14,6.73)ng/L]in remission and the levels of CRP,ESR,WBC count and PLT count also increased significantly,while HB and ALB levels were signifi-cantly lower than those in remission(all P value<0.001).In endoscopically active UC patients,the levels of FC[1117.1(916.5,1492. 4)μg/g]and IL-6[18.18(12.72,33.25)ng/L]were significantly higher than those of mild-moderate UC[622.4(218.7,924.2)μg/g,8.27(7.08,16.60)ng/L](P<0.05)and the levels of CRP,ESR and WBC also increased significantly(P<0.05),while the ALB showed a significant lower level(P=0.002). When FC>175.6 μg/g,it was of higher accuracy in diagnosing UC endoscopic activity and the sensitivity,specificity,positive predictive value and negative predictive value were respectively 87.50%,90.91%,95.45%and 76.92%;When FC>781.1 μg/g,it was of higher accuracy in diagnosing severe UC and the sensitivity,specificity,positive predic-tive value and negative predictive value were respectively 88.89%,73.33%,66.66% and 91.66%. The levels of FC,PCT,IL-6, CRP,ESR,WBC and PLT all presented positive correlation with UCEIS(P<0.001),while the HB and ALB levels showed a negative correlation with UCEIS(P<0.001). Conclusion FC is a good indicator to judge UC endoscopic activity and severe UC. FC can be used as a non-invasive and surrogate marker for endoscopy to monitor UC disease activity in clinical practice.