Role of serum procalcitonin in evaluating disease activity of 107 patients with inflammatory bowel disease
10.3760/cma.j.issn.0254-1432.2017.04.003
- VernacularTitle:血清降钙素原评估炎症性肠病活动度107例初探
- Author:
Yi ZHANG
;
Peixue WANG
;
Jingjing MA
;
Hongjie ZHANG
- Keywords:
Procalcitonin;
Serum biological inflammatory biomarkers;
Inflammatory bowel disease;
Crohn's disease;
Colitis;
ulcerative
- From:
Chinese Journal of Digestion
2017;37(4):232-237
- CountryChina
- Language:Chinese
-
Abstract:
Objective To preliminarily investigate the clinical value of serum procalciton as a noninvasive marker in disease activity assessment in inflammatory bowel disease (IBD).Methods From January 2014 to June 2016,clinical data of 107 IBD patients were collected,including biological inflammatory parameters of peripheral blood such as serum procalcitonin levels,C-reactive protein (CRP) levels,erythrocyte sedimentation rate (ESR) and platelet count,clinical disease activity scores and endoscopic activity scores.The serum level of procalcitonin was measured using the traditional electrochemiluminescence immunoassay (ECL) method.The accuracy of diagnosis was analyzed by receiver operating characteristic (ROC) analysis.Kruskal-Wallis test and Spearman's rank correlation were performed for comparison between groups and correlation analysis.Results In the 60 patients with Crohn's disease (CD),the median serum level of procalcitonin of patients in active phase was higher than that of patients in remission phase (0.066 mg/L,0.047 mg/L to 0.168 rng/L vs 0.033 mg/L,0.024 mg/L to 0.044 mg/L),the median serum level of procalcitonin of patients in moderate to severe active phase was higher than that of patients in mild phase (0.112 mg/L,0.062 mg/L to 0.234 mg/L vs 0.046 mg/L,0.040 mg/L to 0.054 mg/L),and the differences were statistically significant (Z=4.883 and 3.326,both P<0.01).There was a positive correlation between serum procalcitonin level and CRP,ESR,platelet count,plateletcrit,Crohn's disease activity index (CDAI) and Crohn's disease endoscopic index of severity (CDEIS) (r=0.494,0.387,0.339,0.328,0.736 and 0.689,all P<0.05).The sensitivity and specificity of serum procalcitonin level ≥ 0.055 mg/L in predicting moderate to severe active CD were 85.0% and 88.9%,respectively.The area under ROC curve (AUC) value of the combination of procalcitonin and CRP in diagnosing moderate to severe active CD was 0.905 (95 %CI 0.827 to 0.982).In the 47 patients with ulcerative colitis (UC),the median serum procalcitonin level of patients in moderate to severe active phase was higher than those of patients in mild active phase and remission phase (0.059 mg/L,0.033 mg/L to 0.100 mg/L;0.030 mg/L,0.020 mg/L to 0.048 mg/L;0.030 mg/L,0.021 mg/L to 0.057 mg/L),and the differences were statistically significant (Z=2.056 and 2.783,P=0.040 and 0.005).Serum procalcitonin level was positively correlated with Mayo score,CRP level and Baron score (r=0.468,0.573 and 0.347,all P<0.05).The specificity of serum procalcitonin level ≥0.065 mg/L in predicting moderate to severe active ulcerative colitis diagnosis was high but the sensitivity was low.Conclusion Serum procalcitonin may be of value in indicating the disease activity and severity.