Diagnostic Value Of Fecal Calprotectin In The Intestinal Diseases

Object:As the common digestive tract diseases,inflammatory bowel disease,colorectal cancer and irritable bowel disease have the similar symptoms in clinic that need to be differentiated.The purpose of this experiment is to assess the value of fecal calprotectin as a marker in differential diagnosis of inflammatory bowel disease,colorectal cancer and irritable bowel disease.Methods:1.Patients:100 patients who were hospitalized in the departments of gastroenterology,general surgery and oncology of the First Affiliated Hospital of Dalian Medical University between January in 2016 to January in 2017 were collected,40 patients with IBD were included,among which 31 ulcerative colitis patients were enrolled,19 males and 12 females,age between 23-75,average age were 42 years old;The other 9 subjects were Crohn’ s disease patients,including 7 males and 2 females,age between 16-62,average age were 35 years old.Diagnosis of ulcerative colitis and Crohn’s disease was based on the Diagnosis and Treatment of Inflammatory Bowel Disease Consensus(2012·Guangzhou).30 colorectal cancer patients,including 17 males and 13 females,42 to 79 years old,average age were 59 years old,were confirmed by colonoscopy and pathology.No abnormality were found by colonoscopy in 30 irritable bowel disease patients,including 13 males,17 females,between 16-62 years old,average age were 47 years old.Diagnosis of irritable bowel disease was based on the diagnostic criteria of Rome III.30 patients who taking well-being in the First Affiliated Hospital of Dalian Medical University between October in 2017 to December in 2017 were collected.15 males,15 females,age between 25-70,average age were 44 years old.All the candidates were excluded from severe upper gastrointestinal bleeding,severe psychosomatic disease.Immunosuppressor,glucocoticoid,non-steroidal antinflammatory drugs user recently,alcohol abuse and pregnant women were not enrolled.2.Sampling:The fresh stool of 10-20g was collected from all candidates one week before endoscopic examination.The management of the samples was operated strictly in accordance with the instructions of the fecal calprotectin test kit.The supernatant of the samples was kept in-20℃.3.Fecal calprotectin was measured by anenzyme-linked immunosorbent assay(ELISA).4.Statistical analysis:Fecal calprotectin levels were non normal distribution.Therefore,we calculated the median,four bit spacing,and full distance.Data was analyzedusing SPSS23.0 statistical software.Result:1.Themedian of fecalcalprotectin levels were 576.67 μg/g,105.00 μ g/g,54.00 μg/g,44.00 μ g/g in patients with inflammatory bowel disease,colorectal cancer and irritable bowel disease,respectively.2.The fecal calprotectin level higher than 50 μ g/g was regarded as the positive value.The positive rate was 95%in inflammatory bowel disease group,86.67%in colorectal cancer group,8.00%in irritable bowel disease group and 6.67%in healthy control group.3.Comparison of fecal claprotectin level between groups:Themedian of fecalcalprotectin in inflammatory bowel disease group was 576.67 μg/g,in colorectal cancer group was 105.00 μg/g.The difference was statistically significant(P=0.000<0.05);The median of fecal calprotectin in inflammatory bowel disease group was 576.67 u g/g,in irritable bowel disease group was 54.00 μg/g.The difference was statistically significant(P=0.000<0.05);The median of fecal calprotectin in inflammatory bowel disease group was 576.67 u g/g,in normal control group was 44.00 μg/g.The difference was statistically significant(P=0.000<0.05);The median of fecal calprotectin in colorectal cancer group was 105.00 μg/g,in irritable bowel disease group was 54.00 μg/g.The difference was statistically significant(P=0.003<0.05);The median of fecal calprotectin in colorectal cancer group was 105.00 μg/g,in normal control group was 44.00 μg/g.The difference was statistically significant(P＝0.003<0.05);The median of fecal calprotectin in irritable bowel disease group was 54.00 μg/g,in normal control group was 44.00 μg/g.The difference was no statistically significant(P=-1.000>0.05).Conclusion:The fecal calprotectin could accurately distinguish the intestinal organic disease from intestinal functional diseases.It is also an accurate parameter in differentiating inflammatory bowel Disease from colorectal cancer.As a simple and convenient measurement,it has important significance in the differential diagnosis of intestinal diseases.Moreover,it can serve as an important tool to avoid excessive examination in patients with intestinal functional disease.Therefore,it is worthy of extensive clinical application.