Objective: Fecal calprotectin (FC) is a promising marker for assessment of inflammatory bowel disease (IBD) activity. However, the utility of FC for predicting mucosal healing (MH) of IBD patients has yet to be clearly demonstrated. The objective of our study was to perform a meta-analysis evaluating the diagnostic accuracy of FC in predicting MH of IBD patients. Methods: We systematically searched the databases for studies from inception to April 2020 that evaluated MH in IBD. The methodological quality of each study was assessed according to the Quality Assessment of Diagnostic Accuracy Studies checklist. The extracted data were pooled using a summary receiver operating characteristic curve model. Random-effects model was used to summarize the diagnostic odds ratio, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Results: Sixteen studies comprising 1,682 ulcerative colitis (UC) patients and 4 studies comprising 221 Crohn’s disease (CD) patients were included. The best performance of FC for predicting MH in UC was at cut-off range of 60–75 μg/g with area under the curve (AUC) of 0.88 and pooled sensitivity and specificity of 0.87 and 0.79, respectively. The pooled sensitivity and specificity values of cutoff range 180–250 μg/g for predicting MH in CD were 0.67 and 0.76, respectively. The AUC of 0.79 also revealed improved discrimination for identifying MH in CD with FC concentration. Conclusion: Our meta-analysis has found that FC is a simple, reliable noninvasive marker for predicting MH in IBD patients. FC cutoff range 60–75 μg/g appears to have the best overall accuracy in UC patients.
Visc Med

中文翻译：

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预测炎症性肠病患者黏膜愈合的最佳粪便钙卫蛋白范围：系统评价和荟萃分析

目的：粪便钙卫蛋白 (FC) 是评估炎症性肠病 (IBD) 活动的有前景的标志物。然而，FC 用于预测 IBD 患者黏膜愈合 (MH) 的效用尚未得到明确证明。我们研究的目的是进行一项荟萃分析，评估 FC 在预测 IBD 患者 MH 方面的诊断准确性。方法：我们系统地搜索了数据库中从开始到 2020 年 4 月评估 IBD 中 MH 的研究。根据诊断准确性研究的质量评估清单评估每项研究的方法学质量。使用汇总接收器操作特征曲线模型汇总提取的数据。随机效应模型用于总结诊断优势比、敏感性、特异性、阳性似然比和阴性似然比。结果：包括 1,682 名溃疡性结肠炎 (UC) 患者的 16 项研究和包括 221 名克罗恩病 (CD) 患者的 4 项研究。FC 在 UC 中预测 MH 的最佳性能是在 60-75 μg/g 的截止范围内，曲线下面积 (AUC) 为 0.88，汇总的敏感性和特异性分别为 0.87 和 0.79。用于预测 CD 中 MH 的截止范围 180-250 μg/g 的汇总敏感性和特异性值分别为 0.67 和 0.76。0.79 的 AUC 还揭示了在 CD 中用 FC 浓度识别 MH 的鉴别能力有所提高。结论：我们的荟萃分析发现，FC 是一种简单、可靠的非侵入性标志物，可用于预测 IBD 患者的 MH。FC 截止范围 60–75 μg/g 似乎在 UC 患者中具有最佳的总体准确度。
粘性医学