Diagnotic Value Of Serum Calprotectin On Disease Activity In Inflammatory Bowel Disease

ObjectiveOur aim was to to explore the possibility and clinical application of SCP as a biomarkerfor IBD in determining disease activity via measure the level of serumcalprotectin(SCP),compared with other commonly-used markers and evaluated itscorrelation with clinical disease activity (Inflammatory bowel disease activity index(IBDAI))endoscopic activity(IBDEIS)and severity of histopathologic changes.MethodsFifty-three IBD patients (including39patients with Ulcerative colitis,14patients withCrohn’s disease)were enrolled in the study who underwent colonoscope and biopsy in ourhospital,between January2013and January2014.The average age is42years(29.5-50years).All the IBD patients were divided into2groups:the remittent stage group(n=14) andthe active stage group(n=39) according to the activity of IBD judged by Souther-land indexand Harvey-Bradshaw standard.The control group consisted of Forty-two subjects(with noconfirmed abnormality in the upper or lower digestive tract),who underwent stomachacheand diarrhea,the average age is45years(34-57years).Enzyme-linked immunosorbentassay(ELISA) was used to measure SCP level,and the levels of serum C-reactive protein(CRP) and Erythrocyte sedimentation rate (ESR) were also measured. The Student’s t testwas used to assess differences in the laboratory parameters between thesegroups,Spearmans’correlation was used to analyze the correlation between theparameters;The receiver operating characteristics (ROC)(sensitivity and specificity) wereassessed by the curve analysis as described by Henderson，in order to evaluate the value ofSCP as a biomarker for IBD.Results1.The SCP level among patients with IBD(110.90±62.89μg/ml) was significantly higher than that of the control group(37.12±30.77μg/ml, P<0.001).2.The SCP level among patients with active IBD (136.95±48.42μg/ml) was significantlyhigher than that of inactive IBD group (50.11±26.11μg/ml,P<0.001) and the controlgroup(37.12±30.77μg/ml,P<0.001),while the difference between the inactive and the controlgroup was not statistically significant(P>0.05).3.The SCP levels among patients with different active grades of active IBD were96.54±23.56μg/ml,124.42±13.64μg/ml,177.61±45.83μg/ml,significant difference wasexisted between each active grades.4.SCP had a sensitivity of97.4%and specificity of92.9%when evaluate disease activityof IBD,which was significantly higher than that of CRP(sensitivity of74.4%, specificity of92.9%) and ESR (sensitivity of64.1%, specificity of85.7%).5.There is a significant correlation between the SCP level and the endoscopic grades ofIBD activity(r=0.837,P<0.01),and it was significantly higher than that of CRP andESR(CRP:r=0.797,P<0.01;ESR:r=0.546,P<0.01).6.The results revealed a significant correlation between the histopathologic grades ofactive UC and SCP level(r=0.749,P<0.01).The correlation coefficient between CRP/ESRand histological grades were r=0.653(P<0.05) and r=0.229(P>0.05) respectively.Both werelower than that of SCP.ConclusionSCP levels can reflect the disease activity in IBD objectively,and that have a significantcorrelation with both the endoscopic grades and histopathologic grades of IBD activity, SCPis an simple,sensitive,economic and highly specific measurement, it has an abroad clinicalapplication value.