| Abstract | Cilj istraživanja: Sindrom iritabilnog kolona česta je bolest probavnog sustava. Prevalencija sindroma iritabilnog kolona u zapadnim zemljama iznosi 8-19%.Najbolji način za dijagnosticiranje ovog sindroma je kombinacija simptomatologije, isključivanje drugih gastrointestinalnih bolesti i pozitivni biomarkeri kao što je fekalni kalprotektin. Cilj ovog istraživanja je usporediti razinu fekalnog kalprotektina s patohistološkim promjenama u sluznici debelog crijeva ispitanika dijagnosticiranih u Kliničkom zavodu za patologiju, sudsku medicinu i citologiju KBC-a Split.
Ispitanici i metode: Analizirano je 16 patohistoloških nalaza bolesnika s dijagnozom iritabilnog kolona. Podatci su prikupljeni iz medicinske dokumentacije Gastroenterološke ambulante Klinike za unutarnje bolesti te Arhive patohistoloških nalaza Odjela za patologiju u Kliničkom zavodu za patologiju, sudsku medicinu i citologiju Kliničkog Bolničkog Centra Split. Svakom ispitaniku analizirani su simptomi prema Rimskim kriterijima, dob, spol, razina fekalnog kalprotektina (referentne vrijednosti su <30 μg/g), te patohistološke promjene u sluznici debelog crijeva (kronična upala i kronična aktivna upala).
Rezultati: Od ukupnog broja bolesnika sa sindromom iritabilnog kolona (n=16), na muškarce otpada 4 (25%), a na žene 12 (75%), što ukazuje na 3 puta učestalije obolijevanje kod žena nego kod muškaraca. Prosječna dob bolesnika sa sindromom iritabilnog kolona je 36 godina (raspon 16-54). Analiza je pokazala da najviše bolesnika ima između 30 i 40 godina (43,75 %). Od ukupnog broja bolesnika u studiji, 43,75% ima razinu kalprotektina između 70 i 200. 25% bolesnika nema nikakav upalni infiltrat u sluznici debelog crijeva, a najveći broj bolesnika ima srednje gusti upalni infiltrat (43,75%). Kod 6,25% je pronađen gusti upalni infiltrat, a aktivnu upalu ima također 6,25% bolesnika. Od ispitanika koji nemaju povišene vrijednosti kalprotektina (<30 µg/g) njih 4 (80%) ima srednje obilan kronični upalni infiltrat, a 1 ispitanik (20%) nema patološke promjene u sluznici debelog crijeva.Od ispitanika koji imaju povišenu razinu fekalnog kalprotektina njih 3 (27,27%) nema upalne promjene, a 3 (27,27%) ima oskudan, 3 (27,27%) ima srednje obilan, 1 (9,09%) ima obilan kronični upalni infiltrat i 1 ispitanik (9,09%) ima kroničnu aktivnu upalu u sluznici debelog crijeva.
Zaključci: Brojna istraživanja su pokazala da je razina kalprotektina bitna za diferencijalnu dijagnozu idiopatskih upalnih bolesti crijeva i sindroma iritabilnog kolona. U ovom radu, veliki dio ispitanika s povišenom vrijednosti fekalnog kalprotektina (u rasponu 31 - 209 µg/g) ima kronične upalne promjene, a manji dio nema upalne promjene u sluznici debelog crijeva. Od ispitanika koji nemaju povišene vrijednosti kalprotektina (<30 µg/g), većina ima srednje obilan kronični upalni infiltrat, a mali dio ispitanika nema patološke promjene u sluznici debelog crijeva. |
| Abstract (english) | Objectives and Background: Irritable bowel syndrome is a common disease of the digestive system. The prevalence of irritable bowel syndrome in Western countries is 8-19%. The best way to diagnose this syndrome is a combination of symptoms, the exclusion of other gastrointestinal diseases and positive biomarkers such as fecal calprotectin. The aim of this study was to compare the level of fecal calprotectin with histopathological changes in the mucosa of the large intestine patients that are diagnosed in the Department of Pathology, Forensic Medicine and Cytology KBC Split.
Patients and Methods: A total of 16 histopathological analysis of patients diagnosed with irritable colon were analised. Data was collected from medical records of Gastroenterological clinics University Department of Medicine and from Archives of histopathological analysis of the Department of Pathology in the Department of Pathology, Forensic Medicine and Cytology, University Hospital Split. Each pacient was analyzed according to the Rome criteria, symptoms, age, sex, level of fecal calprotectin (reference values are <30 μg/g), and histopathological changes in the mucosa of the large intestine (chronic inflammation and chronic active inflammation).
Results: Of the total number of patients with irritable bowel syndrome (n = 16), only 4 are men (25%), and 12 women (75%), which indicates 3 times greater frequency in women than in men. The average age of patients with irritable bowel syndrome was 36 years (range 16-54). The analysis showed that most patients are between 30 and 40 years (43,75%). Of the total number of patients in the study, 43,75% have levels of calprotectin between 70 and 200. 25% of patients have no inflammatory infiltrate in the mucosa of the colon, and the largest number of patients have medium dense inflammatory infiltrate (43,75%). In 6,25% was found dense inflammatory infiltrate, and also 6,25% of patients have active inflammation. Of those who don’t have elevated calprotectin values (<30 µg/g ), 4 (80%) have a medium dense inflammatory infiltrate, and one (20%) has no pathological changes in the mucosa of the colon. Of those who have elevated levels of fecal calprotectin, 3 (27,27%) have no inflammatory changes, 3 (27,27%) have a low dense inflammatory infiltrate, 3 (27,27%) have medium dense inflammatory infiltrate,1 (9,09%) has high dense inflammatory infiltrate, and 1 pacient (9,09%) has chronic active inflammation in the mucosa of the large intestine.
Conclusions: Numerous studies have shown that levels of calprotectin are essential for the differential diagnosis of idiopathic inflammatory bowel disease and irritable bowel syndrome. In this study, most of the patients with elevated fecal calprotectin values (ranging from 31 to 209µg/g ), have chronic inflammatory changes, and few of them have no inflammation in the mucosa of the large intestine. Of those who have elevated calprotectin values (<30µg/g ), most have a medium dense chronic inflammatory infiltrate, and few of them have no pathological changes in the mucosa of the large intestine. |
