Fecal Calprotectin Combined With Simplified Crohn's Disease Activity Index Predicts Endoscopic Status in Crohn's Disease
10.3969/j.issn.1008-7125.2024.09.002
- VernacularTitle:粪钙卫蛋白联合简化克罗恩病活动指数预测克罗恩病内镜下状态
- Author:
Junyi WU
1
;
Zhe ZHANG
;
Hongliang HUANG
;
Min ZHU
;
Yungang WANG
;
Wei WANG
Author Information
1. 南京大学医学院附属盐城第一医院消化内科(224005);盐城市亭湖区人民医院消化内科
- Publication Type:Journal Article
- Keywords:
Crohn Disease;
Simplified Crohn's Disease Activity Index;
Simple Endoscopic Score for Crohn's Disease;
Fecal Calprotectin
- From:
Chinese Journal of Gastroenterology
2024;29(9):521-528
- CountryChina
- Language:Chinese
-
Abstract:
Background:The endoscopic activity of Crohn's disease(CD)is now an important indicator for judging the prognosis of the disease.Endoscopy is accurate but is not suitable for frequent use.The simplified Crohn's disease activity index(sCDAI)is a convenient clinical activity assessment tool,but its efficacy in predicting endoscopic activity alone is generally average.Aims:To investigate the feasibility and effectiveness of combining fecal calprotectin(FC)with the sCDAI in assessing the endoscopic remission status of CD patients.Methods:The correlation between sCDAI and endoscopic scores was analyzed.The differences in the median distribution of endoscopic scores among different sCDAI score groups were compared.The correlations between FC,C-reactive protein(CRP),and the systemic inflammatory index(SII)with endoscopic scores were evaluated.The threshold of FC for predicting endoscopic remission was determined using the ROC curve.The predictive performance indicators(sensitivity,specificity,and accuracy)of using FC alone and combining FC with sCDAI in predicting endoscopic remission were compared.Results:There were significant differences in the median simple endoscopic score for Crohn's disease(SES-CD)among different sCDAI groups(P<0.05).SES-CD scores were significantly positively correlated with FC(r=0.403,P<0.05)and CRP(r=0.351,P<0.05),but not significantly correlated with SII(r=0.184,P=0.110).There was a significant difference in FC levels between the endoscopic remission group and the active group(P<0.05).The sensitivity,specificity,and accuracy of using FC alone to predict endoscopic remission were 0.75,0.59,and 0.72,respectively.The predictive scheme combining FC and sCDAI showed higher sensitivity(0.85)and accuracy(0.78),but slightly lower specificity(0.53).Conclusions:The combination of FC and sCDAI show higher sensitivity and accuracy in predicting the endoscopic remission status of CD patients compared to using FC alone.This provides a new perspective and tool for clinical monitoring and efficacy evaluation of CD.