粪便钙卫蛋白测定在门诊常见肠道疾病诊断中的意义

Significances of fecal calprotectin in the differential diagnosis of common intestinal diseases in the out-patient department

摘要:

目的：研究粪便钙卫蛋白在诊断常见肠道疾病-炎症性肠病（inflammatory bowel disease，IBD）、肠易激综合征（irritable bowel syndrome，IBS）、结肠癌中的意义。方法：选取门诊病人新鲜粪便共120例，其中健康对照组、IBS组、IBD组及结肠癌组各30例，用 ELISA法定量检测各组中粪便钙卫蛋白水平，确定钙卫蛋白诊断 IBD及结肠癌的敏感性和特异性，并与传统炎症相关性指标，如红细胞沉降率（erythrocyte sedimentation rate，ESR）、C反应蛋白（C reactive protein，CRP）、白细胞（white blood cell，WBC）计数相比较。结果：IBD组与结肠癌组、IBS组、对照组比较，粪便钙卫蛋白水平的差异均具有统计学意义（P<0.05）。而结肠癌组与IBS组、健康组比较，差异也均具有统计学意义（P<0.05）。CRP、ESR、WBC计数在结肠癌、IBS及正常对照组间差异均无统计学意义（P >0.05），IBS组与 IBD组间 ESR、CRP水平存在显著性差异（P<0.05）。粪便钙卫蛋白诊断 IBD的敏感性为86.7%，特异性为83.3%。钙卫蛋白诊断结肠癌的敏感性为86.7%，特异性为76.7%。结论：粪便钙卫蛋白不仅能够初步筛查肠道器质性疾病和功能性疾病，而且在鉴别IBD和结肠癌方面具有一定的作用。

Abstract:

Objective：To investigate the significances of fecal calprotectin（FC） in the differential diagnosis of common intestinal dis－eases including inflammatory bowel disease（IBD），irritable bowel syndrome（IBS） and colon cancer. Methods：A total of 120 fresh fecal samples were collected from the out-patients and were divided into health control，IBS，IBD and colon cancer groups（n=30）. ELISA was used to quantitatively determine the levels of fecal calprotectin in each group and sensitivity and specificity of the calprotectin diagnosis of IBD and colon cancer，which were compared with traditional inflammation indicators including erythrocyte sedimentation rate（ESR），C reactive protein（CRP） and white blood cell count（WBC）. Results：There were statistically significant dif－ferences in levels of fecal calprotectin between IBD group and colon cancer，IBS and healthy control groups（P<0.05）. There were sta－tistically significant differences in levels of fecal calprotectin between colon cancer group and IBS and healthy control groups（P<0.05）. There was no statistical difference in CRP，ESR and WBC levels between colon cancer，IBS and healthy control groups（P >0.05）. There were statistically significant differences in levels of ESR and CRP between IBS and IBD groups（P<0.05）. Sensitivity and specificity of fecal calprotectin diagnosis of IBD were 86.7% and 83.3% respectively，while those of colon cancer were 86.7% and 83.3%. Conclusions：Fecal calprotectin cannot only accurately distinguish intestinal organic disease and functional diseases，but also plays a role in the identification of IBD and colon cancer.