a Division of Gastroenterology and Hepatology , University of Calgary , Calgary , Alberta , Canada.
b Robarts Clinical Trials Inc ., London , Ontario , Canada.
c Division of Gastroenterology , University of California San Diego , La Jolla , CA , USA.
d Department of Medicine , Western University , London , Ontario , Canada.
e Department of Epidemiology and Biostatistics , Western University , London , Ontario , Canada.
针对克罗恩病（CD）的“治疗目标”范式旨在抑制肠道炎症，需要对疾病活动进行准确而可靠的测量。尽管传统上将内窥镜检查视为黄金标准，但成本，复杂性，资源限制和侵入性是重要的限制。因此，在CD的诊断，监测和治疗中，对于非侵入性血清和粪便生物标志物，即C反应蛋白（CRP）和粪便钙卫蛋白（FC），存在很大的兴趣。研究范围：我们回顾了使用血清CRP和FC区分CD患者与肠易激综合征患者，对CD诊断明确的患者进行疾病活动分类，预测治疗反应可能性的证据，确定在医学或外科手术诱发的无症状患者中有疾病复发风险并作为治疗目标。专家评论：对CRP和FC的准确解释取决于几个因素，包括临床情况，测定的性能特征，指定的检测截止值和疾病的检测前可能性。新兴证据表明，在此评论中所述的特定情况下，CRP和FC是CD管理的有价值的辅助手段。
'Treat-to-target' paradigms in Crohn's disease (CD) directed at suppressing intestinal inflammation require accurate and reliable measures of disease activity. Although endoscopy has traditionally been considered a gold standard, cost, complexity, resource limitations, and invasiveness are important limitations. Hence, substantial interest exists for non-invasive serum and fecal biomarkers, namely C-reactive protein (CRP) and fecal calprotectin (FC), in the diagnosis, monitoring, and treatment of CD. Areas covered: We review the evidence for using serum CRP and FC in distinguishing patients with CD from those with irritable bowel syndrome, categorizing disease activity among patients with an established diagnosis of CD, predicting the likelihood of treatment response, identifying asymptomatic patients in medically or surgically induced remission who are at risk for disease relapse, and as treatment targets. Expert commentary: Accurate interpretation of CRP and FC is dependent on several factors including the clinical context, the performance characteristics of the assay, the specified test cut-offs, and the pre-test probability of disease. Emerging evidence indicates that CRP and FC are valuable adjuncts for the management of CD in specific circumstances described in this review.
