BACKGROUND Early prediction of postoperative recurrence (POR) remains a major concern in Crohn's disease (CD). AIMS To assess serial faecal calprotectin (Fcal) monitoring within the first three months to predict CD endoscopic POR. METHODS In a multicenter randomized controlled trial, CD patients received azathioprine 2.5 mg/kg/day with oral curcumin (3 g/day) or placebo. Fcal was measured at baseline, one month (M1) and M3. Endoscopic POR at M6 was defined as Rutgeerts' index ≥ i2b (central reading). RESULTS Among the 48 patients included, there was no significant difference of median Fcal levels at baseline (p = 0.15), M1 (p = 0.44) and M3 (p = 0.28) between patients with or without endoscopic POR at M6. Fcal kinetics during the first 3 months after surgery was significantly different between the patients with or without POR at M6 (p = 0.021). The median variation between Fcal level at baseline and M3 (ΔFcal M3-M0) was significantly higher in patients with endoscopic POR compared to those without POR (p = 0.01). ΔFcal M3-M0 >+10% demonstrated the best performances to predict endoscopic POR at M6 (AUC=0.73, sensitivity=64.7%[41.1-82.7], specificity=87.5%[68.0-96.3], negative predictive value=77.8%[57.5-91.4] and positive predictive value=78.6%[49.2-95.3]). CONCLUSION Fcal variation within the first three months after ileocolonic resection is a promising predictor of early endoscopic POR in CD patients.

中文翻译：

---

肠切除术后前三个月内粪便钙卫蛋白水平的变化可预测克罗恩病内镜术后复发

背景 术后复发 (POR) 的早期预测仍然是克罗恩病 (CD) 的主要问题。目的 评估前三个月内连续监测粪便钙卫蛋白 (Fcal) 以预测 CD 内镜 POR。方法 在一项多中心随机对照试验中，CD 患者接受硫唑嘌呤 2.5 毫克/千克/天和口服姜黄素（3 克/天）或安慰剂。Fcal 在基线、一个月 (M1) 和 M3 时测量。M6 的内窥镜 POR 被定义为 Rutgeerts 指数 ≥ i2b（中心读数）。结果 在纳入的 48 名患者中，在 M6 时有或没有内镜 POR 的患者在基线 (p = 0.15)、M1 (p = 0.44) 和 M3 (p = 0.28) 时的中位 Fcal 水平没有显着差异。术后前 3 个月的 Fcal 动力学在 M6 时有或没有 POR 的患者之间显着不同（p = 0. 021)。与没有 POR 的患者相比，内窥镜 POR 患者的基线 Fcal 水平和 M3 之间的中值变异 (ΔFcal M3-M0) 显着更高 (p = 0.01)。ΔFcal M3-M0 >+10% 表现出在 M6 预测内镜 POR 的最佳性能（AUC=0.73，灵敏度=64.7%[41.1-82.7]，特异性=87.5%[68.0-96.3]，阴性预测值=77.8%[ 57.5-91.4] 和阳性预测值 = 78.6%[49.2-95.3]）。结论 回结肠切除术后前三个月内的 Fcal 变异是 CD 患者早期内镜 POR 的有希望的预测指标。敏感性=64.7%[41.1-82.7]，特异性=87.5%[68.0-96.3]，阴性预测值=77.8%[57.5-91.4]，阳性预测值=78.6%[49.2-95.3]）。结论 回结肠切除术后前三个月内的 Fcal 变异是 CD 患者早期内镜 POR 的有希望的预测指标。敏感性=64.7%[41.1-82.7]，特异性=87.5%[68.0-96.3]，阴性预测值=77.8%[57.5-91.4]，阳性预测值=78.6%[49.2-95.3]）。结论 回结肠切除术后前三个月内的 Fcal 变异是 CD 患者早期内镜 POR 的有希望的预测指标。