Tu1972 The Use of Fecal Calprotectin to Understand the Expanded Utility of IBD Clinical Disease Activity and Quality of Life Assessments in Crohn's Disease and Ulcerative Colitis

GASTROENTEROLOGY(2016)

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摘要
G A A b st ra ct s collected using retrospective chart review. FC was determined using the Quantitative Lateral Flow Assay, (Buehlmann, Schönenbuch, Switzerland). Initially the 30-300 μg/gr range assay was used and, when initial test was >300 μg/gr, then the 100-1800 range test was used. Endoscopic grading of inflammation were measured using the endoscopic Mayo score for inflammation severity (1= mild, 2=moderate, 3=severe) and the Montreal classification for inflammation location (L1=proctitis, L2=left colitis, L3=proximal colitis). For correlation assessment FC results were grouped to 3 groups: <300, 300-1800, >1800. Correlation was analyzed using the Spearman Correlation index (SPSS). Linear regression model using the PMS, rectal bleeding score and continuous FC results measures was constructed to improve correlations. Results: 40 patients with endoscopy assessment and FC results were included. Of the patients 45% were females, mean age at diagnosis was 37 years, topical therapy alone or in combination was given to 15 (38%) of patients and 22.5%, 10% and 15% received corticosteroids, thiopurines and biologics, respectively. The PMS was 0-3, 4-6 and 7-9 in 18 (45%), 11 27.5%) and 11 (27.5%) of patients, respectively. Low (0-300), moderate (3001800) and high FC (>1800) was measured in 22 (55%), 7 (17.5%) and 11 (27.5%) patients, respectively. Good correlation was seen with inflammation location ( ρ=0.518, p=0.001 Fig.1A) but not with the endoscopic severity score ( ρ =0.258, p=0.104, Fig.1B). Linear regression model modeling disease location and calprotectin score as continuous variables and incorporating rectal bleeding score and Mayo partial clinical score improved location prediction even further with R2=0.68. Conclusion: FC is reasonably accurate in predicting active disease location. This may be improved by adding clinical markers such as rectal bleeding and PMS. Pending larger study validation, FC may be useful to direct topical vs. systemic therapy in UC.
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