Accuracy of Faecal Immunochemical Test to Predict Endoscopic and Histological Healing in Ulcerative Colitis: A Prospective Study Based on Validated Histological Scores
单位:[1]Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing, China临床科室国家中心消化分中心消化内科首都医科大学附属北京友谊医院[2]Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China[3]Department of Anatomical & Cellular Pathology, Chinese University of Hong Kong, Hong Kong, China
Background and Aims: Endoscopic and histological healing are associated with improved clinical outcomes in ulcerative colitis [UC]. We aimed to investigate the predictive value of faecal immunochemical test [FIT] for endoscopic and histological healing in UC. Methods: We measured quantitative FIT and faecal calprotectin [FC] in 140 consecutive UC patients who underwent colonoscopy. We assessed the diagnostic accuracy of FIT for predicting endoscopic healing using the Mayo endoscopic subscore [MES 0/1] and for histological healing using the Geboes score [< 2.0] and Nancy index [grade <= 1]. The predictive abilities of FIT were compared with those of FC. Results: FIT had an area under the curve [AUC] of 0.77 (95% confidence interval [CI] 0.67-0.86, p < 0.001) for endoscopic healing, an AUC of 0.77 [95% CI 0.67-0.86, p < 0.001] using the Geboes score, and 0.77 [95% CI 0.66-0.85, p < 0.001] using the Nancy Index for histological healing. The AUC of FIT was comparable to that of FC for endoscopic healing [p = 0.773] and histological healing [p = 0.767-0.960], and was comparable to colonoscopy for histological healing [p = 0.384-0.673]. FIT < 50 ng/ml predicted endoscopic healing with a sensitivity, specificity, and positive predictive value [PPV] of 72%, 68%, and 82%, respectively, and for histological healing with a sensitivity, specificity, and PPV of 73-75%, 67%, and 78-80%, respectively. Combining FIT with FC led to a higher specificity [90%] for histological healing. Over 85% of patients with FIT < 50 ng/ml and FC < 50 mu g/g achieved histological healing. Conclusions: FIT is highly sensitive and accurate to predict endoscopic and histological healing in UC. It represents a promising non-invasive tool for monitoring mucosal healing in UC.
第一作者单位:[1]Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Disease, Beijing, China[2]Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
通讯作者:
通讯机构:[2]Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China[*1]Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong.
推荐引用方式(GB/T 7714):
Shi Hai Yun,Chan Francis K. L.,Chan Anthony W. H.,et al.Accuracy of Faecal Immunochemical Test to Predict Endoscopic and Histological Healing in Ulcerative Colitis: A Prospective Study Based on Validated Histological Scores[J].JOURNAL of CROHNS & COLITIS.2017,11(9):1071-1077.doi:10.1093/ecco-jcc/jjx088.
APA:
Shi, Hai Yun,Chan, Francis K. L.,Chan, Anthony W. H.,Higashimori, Akira,Kyaw, Moe...&Ng, Siew C..(2017).Accuracy of Faecal Immunochemical Test to Predict Endoscopic and Histological Healing in Ulcerative Colitis: A Prospective Study Based on Validated Histological Scores.JOURNAL of CROHNS & COLITIS,11,(9)
MLA:
Shi, Hai Yun,et al."Accuracy of Faecal Immunochemical Test to Predict Endoscopic and Histological Healing in Ulcerative Colitis: A Prospective Study Based on Validated Histological Scores".JOURNAL of CROHNS & COLITIS 11..9(2017):1071-1077