Clinical value of fetal biomarkers for detecting endoscopic activity and postoperative recurrence of Crohn disease / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the value of fecal calprotectin (FC) and stool lactoferrin (SL) for detecting endoscopic activity and monitoring postoperative recurrence of Crohn disease.Methods Publications in Pubmed,Embase,Science Direct,Springer Link,CBM,Cnki,Wan fang and VIP database before January 1 st 2016 were searched manually.Papers were screened according to inclusion and exclusion criteria.Quality assessment was conducted by QUADAS-2 scale.Meta-Disc 1.4 was used to analyze the heterogeneity of included articles.The pooled sensitivity,specificity,positive likelihood,negative likelihood were calculated respectively and the SROC curve was drawn.Stata 12.0 was used to assess the publication bias.Results A total of 19 papers in English language were included.The pooled sensitivities of FC,SL in detecting endoscopic activity and FC in monitoring postoperative recurrence of Crohn disease were 86％ (95％ CI84％-88％),72％ (95 ％ CI66％-79％),80％ (95％ CI75％-84％),respectively.The specificities were 71％ (95％CI67％-75％),84％ (95％ CI74％-91％),65％ (95％ CI59％-70％),respectively.The areas under the SROC curve were 0.865 6,0.834 6,0.811 0 respectively.The cut-off values of FC in detecting endoscopic activity of Crohn disease were set to ＜ 100 μg/g,100-＜200 μg/g or ≥ 200 μg/g with the area under the SROC curve being 0.898 7,0.788 8,0.888 8,respectively.The cut-off values of FC in monitoring postoperative recurrence of Crohn disease were set to 100-＜ 150 μg/g,150-＜200 μg/g or ≥ 200 μg/g with the areas under the SROC curve being 0.677 4,0.859 4 and 0.759 5,respectively.Conclusion FC and SL have higher diagnostic efficiency than C-reaction protein and are worthy of clinical promotion in detecting endoscopic activity and monitoring postoperative recurrence of Crohn disease.However,endoscopy cannot be replaced.