| ObjectiveColorectal polyps are important precancerous lesions of colorectal cancer(CRC).Inflammatory cells can release calprotectin after being stimulated by inflammation.Colorectal polyps are associated with chronic inflammation of the intestine.Existing research results have indicated that the expression of calprotectin in the stool of patients with colorectal polyps was higher than the normal standard,but it has not been reported as an opportunistic screening for CRC and precancerous lesions.The main observation index is FCP level of patients with colorectal polyps,explore whether FCP can be used as the opportunistic screening method of colorectal polyps.Materials and MethodsIn this study,a total of 300 patients who underwent diagnostic digestive endoscopies due to non-specific gastrointestinal symptoms or normal physical examination at the Department of Gastroenterology,Qianfoshan Hospital between October,2018 and January,2021 were enrolled.We collected the stool sample before the intestinal preparation of the patient,and put the stool in the refrigerator at 4℃.The FCP result was tested within 7 days after the sample was collected,and the FCP level was determined by Fluorescence immunochromatography assay(FICA).We collected FOBT results and used SPSS 23.0 for analysis.The correlation between FCP and disease in each group was judged by Spearman correlation analysis.To judge the correlation between FCP and diseases of each group by Spearman correlation analysis.Determine the cut-off value by constructing the ROC curve and calculate the AUC.Furthermore,the sensitivity and specificity were compared by measuring χ test.ResultsBased on the colonoscopy results and tissue biopsy pathological results,a total of 6 cases of incomplete intestinal cleansing were ruled out.In the end,a total of 294 samples met the final research requirement 130 males and 164 females),and age was 56(47-67)years old.The samples were divided into 100 cases in the control group and 194 cases in the colorectal diseases group.The colorectal diseases group could be further divided into 133 cases in the colorectal polyp group,24 cases in the chronic colorectal inflammation group,26 cases in the IBD group,and 11 cases belonging to the CRC group(colorectal adenocarcinoma 4 cases,colorectal early cancer 7 cases).The FCP level of control patients was 16.4(6.05-30.2)μg/g,colorectal diseases group was 116.4(46.9-185.3),colorectal polyp group was 95.5(43.3-143.5)μg/g,inflammation group was 127.1(25.7-187.4)μg/g,IBD group was 234.0(106.2-349.0)μg/g and CRC group was 200.0(143.0-244.0)μg/g.Results of comparison:The FCP levels of the colorectal diseases group,polyp group,inflammation group,IBD group and CRC group were significantly improved compared to the normal reference standard,with statistical differences(P all<0.05).FCP of the inflammation group was no statistical difference with the polyp group(P=0.659).In contrast to the FCP level of the polyp group and inflammation group,the FCP level of the IBD group was significantly improved,with statistical differences(P<0.001,0.001,respectively).Resemblely,the FCP level of the CRC group was statistically different with the FCP of the polyp and inflammation group(P=0.001,0.027.respectively).The IBD group FCP level was no statistical difference to the CRC group(p=0.242).Depending on the different parts of the intestine where the polyp was located,we further divided polyps group into 3 groups,FCP level of right colon polyp group was 99.00(58.05-152.00)μg/g,FCP level of left colon polyp group was 107(47.88-144.50)μg/g,and FCP level of multiple site polyp group was 55.40(22.60-136.00)μg/g.with no statistical difference(P all>0.05).According to the size of polyps,they are divided into 3 groups,<5mm polyp group FCP level was 92.90(47.50-137.40)μg/g,5-10mm polyp group FCP level was 111.00(41.10-163.10)μg/g and ≥10mm polyp group FCP level was 129.00(71.00-142.300)μg/g,with no statistical difference(P all>0.05).Because of the different amount of polyps,they were divided into two groups,single polyp group FCP level was 101.0(47.50-144.00)μg/g and multiple polyp group FCP level was 93.95(42.45-143.50)μg/g,with no statistical difference(P=0.775).Because of pathological types of polyps,they were divided into two groups:adenomatous polyps group FCP level was 102.00(48.58-152.00)μg/g,non-adenomatous polyps group FCP level was 88.00(41.10-134.85)μg/g.The FCP levels of the two groups of patients were similar(P=0.337).We further evaluated the correlation between FCP levels and diseases.The result of Spearman correlation analysis:FCP level has a significant correlation with colorectal disease group,colorectal polyps group,inflammation group,CRC group and IBD group(rs=0.647,0.651,0.454,0.495,0.652,P<0.001),and FCP has the strongest correlation with IBD.We further constructed the ROC curve of each group.FCP has significant diagnostic value for colorectal disease group,CRC group and colorectal polyps group,and there were statistical differences(P all<0.001).The AUC were 0.894(95%CI 0.858-0.930),0.825(95%CI 0.727-0.924)and 0.665(95%CI 0.602-0.728),respectively.This study focused on analyzing the diagnostic value of FCP for colorectal polyps and colorectal disease.The best cut-off value of FCP in the diagnosis of colorectal polyps was 37.25μg/g,the corresponding diagnostic sensitivity was 80.5%,and the specificity was 55.9%.Compared with FOBT detection results,the sensitivity of FCP detection in polyp group(80.5%)was significantly higher than that of FOBT(7.5%).The χ2 test showed statistical difference(χ2=143.6,P<0.001).The specificity corresponding to FOBT method(81.4%)in polyp group was higher than that of FCP(55.9%),with statistical difference(χ2=24.3,P<0.001).When FCP combined with FOBT was used to detect colorectal polyps,if one test met a positive result,the diagnosis was considered clear.Compared with the FCP method results,the sensitivity of the fixed method(82.7%)higher than FCP(80.5%),with no statistical difference(χ2=0.225,P=0.635).Compared with the FCP method(55.9%),the specificity of the fixed method(54.7%)was reduced,with no statistical difference(χ2=0.050,P=0.823).Compared with the FOBT method(7.5%),the sensitivity of the combined method was elevated,with statistical differences(χ2=151.8,p<0.001).Compared with the FOBT method(81.4%),the specificity of the fixed method(54.7%)was reduced,with statistical differences(χ2=26.394,p<0.001).Conclusion1.FCP levels were significantly increased in patients with colorectal lesions and in patients with colorectal polyps.2.Elevated FCP levels were significantly related to the presence of colorectal lesions and colorectal polyps.3.FCP could be used as a marker for colorectal polyps and intestinal lesions to be screened.Through FCP testing,patients who must undergo colonoscopy could be screened,thereby increasing the acceptance of endoscopies,increasing the detection rate of colorectal polyp. |
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