Copyright
©The Author(s) 2017.
World J Gastroenterol. Dec 14, 2017; 23(46): 8235-8247
Published online Dec 14, 2017. doi: 10.3748/wjg.v23.i46.8235
Published online Dec 14, 2017. doi: 10.3748/wjg.v23.i46.8235
Table 1 Clinical and demographic characteristics of included patients n (%)
CD | UC | IBS | |
Number of patients, n | 92 | 44 | 25 |
Male | 54 (58.7) | 26 (59.1) | 11 (44) |
Median age at test (range) | 29.5 (18-62) | 38 (19-70) | 35 (21-52) |
Age at diagnosis (yr) | NA | ||
A1 (< 16) | 7 (7.6) | 2 (4.5) | |
A2 (17-40) | 69 (75.0) | 27 (61.4) | |
A3 (> 40) | 16 (17.4) | 15 (34.1) | |
Disease location | NA | ||
Ileum (L1) | 22 (23.9) | NA | |
Colonic (L2) | 10 (10.9) | NA | |
Ileum-Colonic (L3) | 60 (65.2) | NA | |
Upper GI (L4) | 9 (9.8) | NA | |
Rectum (E1) | NA | 15 (34.1) | |
Distal colitis (E2) | NA | 14 (31.8) | |
Extensive colitis (E3) | NA | 15 (34.1) | |
Concomitant medications1 | NA | ||
No medication | 9 (9.8) | 3 (6.8) | |
5-ASA | 28 (30.4) | 37 (84.1) | |
Corticosteroids | 22 (23.9) | 9 (20.5) | |
Immunosuppressants | 39 (42.4) | 1 (2.31) | |
Anti-TNF therapy | 36 (39.1) | 4 (9.1) | |
Previous IBD-related surgery: no/yes | 69/23 | NA | NA |
Table 2 Descriptive statistics of noninvasive evaluations for endoscopy-based classification of inflammation for inflammatory bowel disease and irritable bowel syndrome patients
CICD | CD-related surgery | UC | IBS | ||||
Inactive, n = 21 | Active, n = 35 | Inactive, n = 15 | Active, n = 10 | Inactive, n = 12 | Active, n = 33 | n = 25 | |
FC (µg/g) | |||||||
Median | 131.7213 | 1795.812 | 142.973 | 229.272 | 45.3113 | 690.612 | 9.923 |
Range | (0-658.71) | (264.64-2266.07) | (0.02-1805.0) | (0-1805.0) | (6.7-189.42) | (74.93-2266.01) | (0-385.4) |
CDAI/CAI | NA | ||||||
Median | 63.121 | 168.451 | 81 | 135.64 | 11 | 61 | |
Range | (32.2-155.0) | (46.8-364.0) | (37.8-192.8) | (38. 8-327.1) | (0-4) | (1-17) | |
CRP (mg/L) | NA | ||||||
Median | 0.481 | 20.571 | 2.1 | 4.37 | 0.391 | 41 | |
Range | (0.10-12.88) | (0.2-79.8) | (0.13-134.6) | (0.10-41.20) | (0.04-2.1) | (0.08-65.40) | |
ESR (mm/h) | NA | ||||||
Median | 8.01 | 30.01 | 9 | 17 | 4.31 | 141 | |
Range | (1.0-57.0) | (5.0-123.0) | (1.0-92.0) | (2.0-41.0) | (2.0-15.0) | (2.0-100.0) | |
PCT (ng/mL) | NA | ||||||
Median | 0.037 | 0.043 | 0.028 | 0.025 | 0.028 | 0.025 | |
Range | (0-4.39) | (0-5.02) | (0-0.082) | (0-0.058) | (0-0.082) | (0-0.058) |
Table 3 Noninvasive parameters according to endoscopic activity grade in colonic or ileo-colonic Crohn’s disease patients
Inactive, n1 = 21 | Mild activity, n2 = 8 | Moderate activity, n3 = 9 | Severe activity, n4 = 18 | |||||
FC, median (range) | 125.7(0-658.7) | 717.8 (137.7-1805.0) | 1211.8 (660.8-1805.0) | 1805.0 (264.6-2266.1) | ||||
P value | < 0.05 | NS | < 0.05 | |||||
CDAI, median (range) | 63.1 (32.2-155.0) | 125.4 (46.8-157.8) | 145.1 (75.0-234.9) | 201.4 (64.7-364.0) | ||||
P value | < 0.05 | NS | < 0.05 | |||||
CRP, median (range) | 0.48(0.1-12.9) | 5.1 (0.20-48.1) | 15.0 (0.6-70.8) | 30.6 (1.1-79.8) | ||||
P value | NS | NS | < 0.05 | |||||
ESR, median (range) | 8.0(1.0-57.0) | 22.0 (5.0-68.0) | 28.0 (8.9-95.0) | 37.0 (5.5-123.0) | ||||
P value | NS | NS | < 0.05 | |||||
PCT, median (range) | 0.037 (0-4.39) | 0.038 (0.021-0.064) | 0.038 (0-0.137) | 0.049 (0.02-5.02) | ||||
P value | NS | NS | NS |
Table 4 Noninvasive parameters according to endoscopic activity grade in ulcerative colitis patients
Inactive, n1 = 12 | Mild activity, n2 = 12 | Moderate activity, n3 = 16 | Severe activity, n4 = 5 | |||||
FC, median (range) | 45.3 (6.7-189.42) | 474.8 (74.9-1805.0) | 769.9 (186.8-2266.1) | 1704.6 (788.4-2092.4) | ||||
P value | < 0.001 | NS | < 0.05 | |||||
CAI, median (range) | 1 (0-4) | 2.5 (1-8) | 6.5 (2-17) | 9 (8-15) | ||||
P value | < 0.05 | < 0.001 | NS | |||||
CRP, median (range) | 0.39 (0.04-2.10) | 1.9 (0.26-65.40) | 4.7 (0.08-28.19) | 16.4 (7.1-53.2) | ||||
P value | NS | NS | < 0.05 | |||||
ESR, median (range) | 4.3 (2.0-15.0) | 8.5 (2.0-40.0) | 14.0 (2.0-88.0) | 45.0 (24.0-100.0) | ||||
P value | NS | NS | < 0.05 | |||||
PCT, median (range) | 0.03 (0-0.041) | 0.031 (0.023-0.127) | 0.044 (0.021-0.538) | 0.035 (0.026-0.085) | ||||
P value | NS | NS | NS |
Table 5 Sensitivity, specificity, positive predictive value, and negative predictive value of fecal calprotectin, CRP, and ESR in predicting endoscopic active disease in inflammatory bowel disease patients in clinical remission
FC ≥ 250 μg/g | CRP ≥ 5 mg/L | ESR ≥ 10 mm/h | |
Colonic or ileum-colonic CD (%) | |||
Sensitivity | 93 | 46.2 | 61.5 |
Specificity | 70 | 83.3 | 66.7 |
PPV | 68.4 | 75.0 | 53.3 |
NPV | 93.3 | 73.1 | 73.7 |
AUC | 0.91 | 0.76 | 0.71 |
P value | < 0.001 | 0.011 | 0.042 |
UC | |||
Sensitivity | 84.6 | 23.1 | 46.2 |
Specificity | 100 | 100 | 83.3 |
PPV | 100 | 100 | 75.0 |
NPV | 85.7 | 54.5 | 58.8 |
AUC | 0.96 | 0.84 | 0.76 |
P value | < 0.001 | 0.004 | 0.028 |
Table 6 Sensitivity, specificity, positive predictive value, and negative predictive value of FC, CDAI/CAI, CRP, ESR, and CAF in predicting endoscopic active disease in three groups of inflammatory bowel disease patients
FC ≥ 250 μg/g | CDAI > 150/CAI > 4 | CRP ≥ 5 mg/L | ESR ≥ 10 mm/h | CFA ≥ 850 or ≥ 150 | |
Colonic or ileum-colonic CD (%) | |||||
Sensitivity | 97.1 | 60 | 71.4 | 82.8 | 91.4 |
Specificity | 71.4 | 95.2 | 90.5 | 57.1 | 90.5 |
PPV | 85 | 95.5 | 92.6 | 76.3 | 94.1 |
NPV | 93.8 | 58.8 | 65.5 | 66.7 | 86.4 |
Accuracy | 87.5 | 73.2 | 78.6 | 73.2 | 91.1 |
CD-related surgery (%) | |||||
Sensitivity | 50.0 | 40.0 | 50.0 | 60.0 | NA |
Specificity | 66.7 | 73.3 | 73.3 | 53.3 | NA |
PPV | 50 | 50.0 | 55.6 | 46.2 | NA |
NPV | 66.7 | 64.7 | 68.8 | 66.7 | NA |
Accuracy | 60 | 60.0 | 64.0 | 56.0 | NA |
UC | |||||
Sensitivity | 87.9 | 60.6 | 42.4 | 63.6 | 92.8 |
Specificity | 100 | 100 | 100 | 83.3 | 91.7 |
PPV | 100 | 100 | 100 | 91.3 | 96.8 |
NPV | 75.0 | 48.0 | 38.7 | 45.5 | 78.6 |
Accuracy | 91.1 | 71.1 | 57.8 | 68.89 | 91.1 |
- Citation: Chen JM, Liu T, Gao S, Tong XD, Deng FH, Nie B. Efficacy of noninvasive evaluations in monitoring inflammatory bowel disease activity: A prospective study in China. World J Gastroenterol 2017; 23(46): 8235-8247
- URL: https://www.wjgnet.com/1007-9327/full/v23/i46/8235.htm
- DOI: https://dx.doi.org/10.3748/wjg.v23.i46.8235