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©The Author(s) 2021.
World J Gastroenterol. Mar 7, 2021; 27(9): 866-885
Published online Mar 7, 2021. doi: 10.3748/wjg.v27.i9.866
Published online Mar 7, 2021. doi: 10.3748/wjg.v27.i9.866
Table 1 Patient demographics and medical characteristics
Parameters | Controls (n = 82) | Crohn’s disease (n = 115) | Ulcerative colitis (n = 51) |
Women | 57 (69.5%) | 58 (50.4%) | 27 (52.9%) |
Age (yr), median (IQR) | 51.5 (36.5-60) | 42 (28-58) | 44 (37-56) |
Disease duration (yr), median (IQR) | 6 (3-11) | 9 (3-14) | |
Age at diagnosis (yr) | |||
A1; A2; A3, n (%) | 10 (8.7); 57 (49.6); 48 (41.7) | 8 (15.7); 29 (56.9); 14 (27.5) | |
Disease behavior | |||
B1; B2; B3, n (%) | 53 (46.1); 20 (17.4); 42 (36.5) | - | |
Disease location | |||
L1; L2; L3/E1; E2; E3, n (%) | 16 (13.9); 39 (33.9); 60 (52.2) | 14 (27.5); 17 (33.3); 20 (39.2) | |
Perianal disease | 23 (20.0%) | - | |
EIM | 12 (10.4%) | 3 (5.9%) | |
PSC | 6 (5.2%) | 5 (9.8%) | |
Previous surgery | 36 (31.3%) | 2 (3.9%) | |
Medical therapy | |||
Biologicals | 38 (33.0%) | 5 (9.8%) | |
Immunosuppressants | 66 (57.4%) | 22 (43.1%) | |
Steroids | 17 (14.8%) | 3 (5.9%) | |
Salicylates | 18 (15.7%) | 26 (51.0%) | |
Clinically active | 60 (52.2%) | 33 (64.7%) | |
Endoscopically active | 77 (66.9%) | 35 (68.6%) | |
Histologically active | 33/71 (46.5%) | 9/29 (31.0%) | |
CRP, mg/L | 1.65 (1.4-6.0) | 2.8 (1.6-8.1) | 4.3 (2.0-7.6) |
ESR, mm/h | 22 (10-30) | 22 (10-42) | 35 (19-67) |
Fecal calprotectin, µg/g | 122 (45-201) | 199 (52-325) | 218 (115-370) |
Beta-glucan, µg/mL | 17 (8-33) | 35 (17-74) | 23 (9-54) |
Table 2 Performance analysis of different cutoff values of serum beta-glucan for patients with Crohn’s disease in relation to endoscopic and histological criteria
Predicted outcome | Cutoff | Sensitivity | Specificity | PPV | NPV | Accuracy | |
Endoscopic inflammation | Beta-glucan | 40 | 50.0 (39.0-61.0) | 71.8 (56.2-83.5) | 77.5 (64.1-87.0) | 42.4 (31.2-54.4) | 57.4 (48.3-66.0) |
(μg/mL) | 60 | 34.2 (24.5-45.4) | 87.2 (73.3-94.4) | 83.9 (67.4-92.9) | 40.5 (30.6-51.2) | 52.2 (43.1-61.1) | |
Calprotectin | 100 | 75.0 (56.6-87.3) | 53.3 (30.1-75.2) | 75.0 (56.6-87.3) | 53.3 (30.1-75.2) | 67.4 (52.5-79.5) | |
(μg/g) | 200 | 53.6 (35.8-70.5) | 66.7 (41.7-84.8) | 75.0 (53.1-88.8) | 43.5 (25.6-63.2) | 58.1 (43.3-71.6) | |
CRP | 3 | 49.2 (37.1-61.4) | 50.0 (31.4-68.6) | 71.4 (56.4-82.8) | 27.9 (16.7-42.7) | 49.4 (39.0-59.8) | |
(mg/L) | 5 | 34.4 (23.7-46.9) | 66.7 (46.7-82.0) | 72.4 (54.3-85.3) | 28.6 (18.4-41.5) | 43.5 (33.5-54.1) | |
Histological inflammation | Beta-glucan | 40 | 78.8 (62.2-89.3) | 60.5 (44.7-74.4) | 63.4 (48.1-76.4) | 76.7 (59.1-88.2) | 69.0 (57.5-78.6) |
(μg/mL) | 60 | 57.6 (40.8-72.8) | 76.3 (60.8-87.0) | 67.9 (49.3-82.1) | 67.5 (52.5-79.5) | 67.6 (56.1-77.3) | |
Calprotectin | 100 | 69.2 (42.4-87.3) | 41.7 (19.3-68.0) | 56.2 (33.2-76.9) | 55.6 (26.7-81.1) | 56.0 (37.1-73.3) | |
(μg/g) | 200 | 46.1 (23.2-70.9) | 50.0 (25.4-74.6) | 50.0 (25.4-74.6) | 46.1 (23.2-70.9) | 48.0 (30.0-66.5) | |
CRP | 3 | 57.7 (38.9-74.5) | 62.1 (44.0-77.3) | 57.7 (38.9-74.5) | 62.1 (44.0-77.3) | 60.0 (46.8-71.9) | |
(mg/L) | 5 | 53.8 (35.5-71.2) | 79.3 (61.6-90.1) | 70.0 (48.1-85.4) | 65.7 (49.1-79.2) | 67.3 (54.1-78.2) |
Table 3 Performance analysis of different cutoff values of serum beta-glucan for patients with ulcerative colitis in relation to endoscopic and histological criteria
Predicted outcome | Cutoff | Sensitivity | Specificity | PPV | NPV | Accuracy | |
Endoscopic inflammation | Beta-glucan | 40 | 40.0 (25.6-56.4) | 87.5 (64.0-96.5) | 87.5 (64.0-96.5) | 40.0 (25.6-56.4) | 54.9 (41.4-67.7) |
(μg/mL) | 60 | 22.9 (12.1-39.0) | 87.5 (64.0-96.5) | 80.0 (49.0-94.3) | 34.1 (21.6-49.4) | 43.1 (30.5-56.7) | |
Calprotectin | 100 | 81.2 (57.0-93.4) | 20.0 (3.6-62.4) | 76.5 (52.7-90.4) | 25.0 (4.6-69.9) | 66.7 (45.4-82.8) | |
(μg/g) | 200 | 62.5 (38.6-81.5) | 80.0 (37.5-96.4) | 90.9 (62.3-98.4) | 40.0 (16.8-68.7) | 66.7 (45.4-82.8) | |
CRP | 3 | 60.9 (40.8-77.8) | 20.0 (5.7-51.0) | 63.7 (42.9-80.3) | 18.2 (5.1-47.7) | 48.5 (32.5-64.8) | |
(mg/L) | 5 | 43.5 (25.6-63.2) | 60.0 (31.3-83.2) | 71.4 (45.3-88.3) | 31.6 (15.4-54.0) | 48.5 (32.5-64.8) | |
Histological inflammation | Beta-glucan | 40 | 66.7 (35.4-87.9) | 90.0 (69.9-97.2) | 75.0 (40.9-92.8) | 85.7 (65.4-95.0) | 82.8 (65.5-92.4) |
(μg/mL) | 60 | 55.6 (26.7-81.1) | 95.0 (76.4-99.1) | 83.3 (43.6-97.0) | 82.6 (62.9-93.0) | 82.8 (65.5-92.4) | |
Calprotectin | 100 | 100.0 (64.6-100.0) | 25.0 (7.1-59.1) | 53.8 (29.1-76.8) | 100.0 (34.2-100.0) | 60.0 (35.7-80.2) | |
(μg/g) | 200 | 85.7 (48.7-97.4) | 50.0 (21.5-78.5) | 60.0 (31.3-83.2) | 80.0 (37.5-96.4) | 66.7 (41.7-84.8) | |
CRP | 3 | 57.1 (25.0-84.2) | 33.3 (13.8-60.9) | 33.3 (13.8-60.9) | 57.1 (25.0-84.2) | 42.1 (23.1-63.7) | |
(mg/L) | 5 | 42.9 (15.8-74.9) | 58.3 (31.9-80.7) | 37.5 (13.7-69.4) | 63.6 (35.4-84.8) | 52.6 (31.7-72.7) |
Table 4 Patient demographics and medical characteristics of the subgroup for the analysis of noninvasive markers
Parameters | Control group (n = 15) | Crohn’s disease group (n = 28) | Ulcerative colitis group (n = 25) | P value |
Women, n (%) | 11 (73) | 12 (43) | 16 (64) | 0.110 |
Age (yr), median (IQR) | 57 (37-63) | 36 (26-58) | 41 (33-56) | 0.158 |
Disease duration (yr), median (IQR) | 6 (2-12.5) | 9 (3-10.5) | 0.521 | |
Age at diagnosis (yr) | ||||
A1; A2; A3, n (%) | 3 (11); 14 (50); 11 (39) | 5 (20); 15 (60); 5 (20) | 0.269 | |
Disease behavior | ||||
B1; B2; B3, n (%) | 16 (57); 4 (14); 8 (29) | - | - | |
Disease location | ||||
L1; L2; L3/E1; E2; E3, n (%) | 5 (18); 9 (32); 14 (50) | 5 (20); 12 (48); 8 (32) | - | |
Perianal disease, n (%) | 5 (18) | - | - | |
EIM, n (%) | 4 (14) | 2 (8) | 0.391 | |
PSC, n (%) | 1 (3.6) | 3 (12) | 0.263 | |
Previous surgery, n (%) | 9 (32) | 1 (4.0) | 0.010 | |
Medical therapy, n (%) | ||||
Biologicals | 10 (36) | 2 (8.0) | 0.017 | |
Immunosuppressants | 18 (64) | 5 (20) | 0.001 | |
Steroids | 8 (29) | 1 (4.0) | 0.019 | |
Salicylates | 6 (21) | 14 (56) | 0.010 | |
Clinically active, n (%) | 13 (46) | 21 (84) | 0.005 | |
Endoscopically active, n (%) | 23 (82) | 17 (68) | 0.191 | |
Histologically active, n (%) | 14/22 (64) | 4/14 (29) | 0.043 | |
Beta-glucan, µg/mL | 26 (8-43) | 79 (30-183) | 23 (9-69) | 0.0003a |
LBP, pg/mL | 19.2 (16.4-22.7) | 27.3 (24.3-28.6) | 21.8 (19.8-24.6) | 0.002b |
Zonulin, pg/mL | 16.4 (15.3-17.1) | 17.6 (16.6-19.0) | 17.2 (16.6-18.7) | 0.09 |
IL-17 (102), pg/mL | 0.04 (0.0-1.50) | 0.08 (0.0-1.75) | 0.00 (0.00-0.60) | 0.2479 |
IFN-gamma, pg/mL | 0.00 (0.00-0.690) | 0.021 (0.00-0.66) | 0.25 (0.001-0.92) | 0.5276 |
TNF-alpha (102), pg/mL | 0.00 (0.00-1.00) | 0.10 (0.00-7.80) | 0.00 (0.00-20.01) | 0.9004 |
IL-10, pg/mL | 0.00 (0.00-0.00) | 0.00 (0.00-4.56) | 1.35 (0.00-3.66) | 0.4801 |
IL-6, pg/mL | 3.27 (2.38-9.05) | 5.70 (0.31-35.73) | 4.35 (2.28-15.91) | 0.4149 |
IL-4, pg/mL | 0.055 (0.00-6.81) | 0.00 (0.00-0.087) | 0.00 (0.00-1.31) | 0.2597 |
IL-2, pg/mL | 0.00 (0.00-0.052) | 0.00 (0.00-0.010) | 0.00 (0.00-0.04) | 0.9204 |
- Citation: Farias e Silva K, Nanini HF, Cascabulho CM, Rosas SLB, Santana PT, Carneiro AJV, Anaissie E, Nucci M, de Souza HSP. Serum 1,3-beta-D-glucan as a noninvasive test to predict histologic activity in patients with inflammatory bowel disease. World J Gastroenterol 2021; 27(9): 866-885
- URL: https://www.wjgnet.com/1007-9327/full/v27/i9/866.htm
- DOI: https://dx.doi.org/10.3748/wjg.v27.i9.866