粪便钙卫蛋白在不同下消化道疾病中的鉴别诊断应用探讨

Application of Fecal Calprotectin in Differential Diagnosis of Different Lower Gastrointestinal Diseases

目的:研究粪便钙卫蛋白(FC)在不同下消化道疾病中的鉴别诊断应用价值。方法:将深圳市坪山区人民医院从2020年1月-2021年3月收治的191例下消化道疾病患者纳入研究,其中肠癌19例(肠癌组),肠炎62例(肠炎组),增生性息肉110例(肠道增生性息肉组),另取同期健康体检人群50例作为对照组进行回顾性分析。分别采集所有受试者的粪便标本,完成FC的检查并对比。分析各组FC检测阳性率情况。以肠道内镜检查切除的组织病理切片结果为金标准,分析FC诊断不同下消化道疾病的效能。结果:肠癌组、肠炎组及肠道增生性息肉组的FC水平分别为(551.32±112.79)、(815.29±214.07)、(144.47±24.67)μg/g,均高于对照组的(35.32±10.38)μg/g,且肠癌、肠炎组FC水平均高于肠道增生性息肉组,肠炎组FC水平高于肠癌组(P<0.05)。肠癌组、肠炎组及肠道增生性息肉组FC检测阳性率均高于对照组,且肠癌组、肠炎组FC检测阳性率均高于肠道增生性息肉组,肠炎组FC检测阳性率高于肠癌组(P<0.05)。以肠道内镜检查切除的组织病理切片结果为金标准,FC检测检出肠癌的灵敏度、特异度及准确度分别为78.95%、96.51%、94.76%;检出肠炎的灵敏度、特异度及准确度分别为83.87%、87.60%、86.39%;检出肠道增生性息肉的灵敏度、特异度及准确度分别为83.64%、90.12%、86.39%。结论:FC鉴别诊断不同下消化道疾病的价值较高,值得临床推广应用。

Objective:To study the value of fecal calprotectin (FC) in differential diagnosis of different lower gastrointestinal diseases.Method:A total of 191 cases of lower gastrointestinal diseases treated in Shenzhen Pingshan District People’s Hospital from January 2020 to March 2021 were included in the study,including 19 cases of intestinal cancer (intestinal cancer group),62 cases of enteritis (enteritis group),and 110 cases of hyperplastic polyps (intestinal hyperplastic polyp group),in addition,50 healthy people undergoing physical examination during the same period were taken as the control group for retrospective analysis.Fecal samples of all subjects were collected,and FC was examined and compared.The positive rates of FC in different lower gastrointestinal diseases and control groups were analyzed.The efficacy of FC in the diagnosis of different lower gastrointestinal diseases was analyzed based on the results of histopathological sections removed by intestinal endoscopy.Result:The FC levels in the intestinal cancer group,the enteritis group and the intestinal hyperplastic polyp group were (551.32±112.79),(815.29±214.07) and (144.47±24.67) μg/g,respectively,which were higher than (35.32±10.38) μg/g in the control group,the FC levels in the intestinal cancer and enteritis groups were higher than that in the intestinal hyperplastic polyp group,the FC level in the enteritis group was higher than that in the intestinal cancer group (P<0.05).The positive rates of FC in the intestinal cancer group,enteritis group and intestinal hyperplastic polyp group were higher than that in the control group,and the FC positive rates in the intestinal cancer group and enteritis group were higher than that in the intestinal hyperplastic polyp group,the FC positive rate in the enteritis group was higher than that in the intestinal cancer group (P<0.05).Taking the pathological sections resected by intestinal endoscopy as the gold standard,the sensitivity,specificity and accuracy of FC in the detection of intestinal cancer were 78.95%,96.51% and 94.76%,respectively.The sensitivity,specificity and accuracy of detecting enteritis were 83.87%,87.60% and 86.39%,respectively.The sensitivity,specificity and accuracy of detecting intestinal hyperplastic polyps were 83.64%,90.12% and 86.39%,respectively.Conclusion:FC has high value in differential diagnosis of different lower gastrointestinal diseases and is worthy of clinical application.