Value of combined measurement of intestinal fatty acid-binding protein and fecal calprotectin in diagnosis of necrotizing enterocolitis in full-term neonates
TIAN Yun-Fen1, LI Li1, MI Hong-Ying1, HUANG-PU Chun-Rong1, HE Shan1, XU Xiao-Yan1, CAO Yong-Jiu2
Department of Pediatrics, First People's Hospital of Yunnan Province, Kunming 650034, China
Abstract:Objective To study the value of combined measurement of intestinal fatty acid-binding protein (I-FABP) and fecal calprotectin (FC) in the diagnosis of necrotizing enterocolitis (NEC) in full-term neonates. Methods A total of 36 full-term neonates with NEC (case group) and 39 neonates without digestive system diseases (control group) were enrolled as study subjects. ELISA was used to measure the serum I-FABP level and fecal FC level, and the clinical value of I-FABP combined with FC in the diagnosis of NEC was evaluated. Results The case group had significantly higher I-FABP and FC levels than the control group (P < 0.05). In the case group, serum I-FABP level was positively correlated with fecal FC level (r=0.71, P < 0.05). In the diagnosis of NEC, I-FABP alone, FC alone, and I-FABP/FC combination had sensitivities of 83.3%, 81.5%, and 79.5%, specificities of 72.5%, 75.8%, and 86.3%, and areas under the ROC curve (AUCs) of 0.82, 0.81, and 0.88. The combined measurement showed significantly higher specificity and AUC than single measurement (P < 0.05). Conclusions Children with NEC have significant increases in I-FABP and FC levels, and there is a correlation between them. Combined measurement of I-FABP and FC can increase the specificity of the diagnosis of NEC.
TIAN Yun-Fen,LI Li,MI Hong-Ying et al. Value of combined measurement of intestinal fatty acid-binding protein and fecal calprotectin in diagnosis of necrotizing enterocolitis in full-term neonates[J]. CJCP, 2016, 18(11): 1080-1083.
Choi YY.Necrotizing enterocolitis in newborns:update in pathophysiology and newly emerging therapeutic strategies[J].Korean J Pediatr,2014,57(12):505-513.
[2]
Kim JH.Necrotizing enterocolitis:the road to zero[J].Semin Fetal Neonatal Med,2014,19(1):39-44.
Sherman MP,Miller MM,Sherman J,et al.Lactoferrin and necrotizing enterocolitis[J].Curr Opin Pediatr,2014,26(2):146-150.
[7]
Chen AC,Chung MY,Chang JH,et al.Pathogenesis implication for necrotizing enterocolitis prevention in preterm very-lowbirth-weight infants[J].J Pediatr Gastroenterol Nutr,2014,58(1):7-11.
[8]
Elgin TG,Kern SL,McElroy SJ.Development of the Neonatal Intestinal Microbiome and Its Association With Necrotizing Enterocolitis[J].Clin Ther,2016,38(4):706-715.
[9]
Gonçalves FL,Soares LM,Figueira RL,et al.Evaluation of the expression of I-FABP and L-FABP in a necrotizing enterocolitis model after the use of Lactobacillus acidophilus[J].J Pediatr Surg,2015,50(4):543-549.
[10]
Mitidiero LF,Simões AL,Gonçalves FL,et al.L-FABP and I-FABP expression in newborn rats changes inversely in the model of necrotizing enterocolitis[J].Acta Cir Bras,2014,29(Suppl 2):43-49.
[11]
Aydemir O,Aydemir C,Sarikabadayi YU,et al.Fecal calprotectin levels are increased in infants with necrotizing enterocolitis[J].J Matern Fetal Neonatal Med,2012,25(11):2237-2241.
[12]
Selimoğlu MA,Temel I,YıldırımÇ,et al.The role of fecal calprotectin and lactoferrin in the diagnosis of necrotizing enterocolitis[J].Pediatr Crit Care Med,2012,13(4):452-454.
[13]
Ng EW,Poon TC,Lam HS,et al.Gut-associated biomarkers L-FABP,I-FABP,and TFF3 and LIT score for diagnosis of surgical necrotizing enterocolitis in preterm infants[J].Ann Surg,2013,258(6):1111-1118.
[14]
Reisinger KW,Van der Zee DC,Brouwers HA,et al.Noninvasive measurement of fecal calprotectin and serum amyloid A combined with intestinal fatty acid-binding protein in necrotizing enterocolitis[J].J Pediatr Surg,2012,47(9):1640-1645.
[15]
Bin-Nun A,Booms C,Sabag N,et al.Rapid fecal calprotectin (FC) analysis:point of care testing for diagnosing early necrotizing enterocolitis[J].Am J Perinatol,2015,32(4):337-342.