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 [PMID: 33727775 DOI: 10.3748/wjg.v27.i9.866]
Corresponding Author of This Article
Heitor Siffert Pereira de Souza, MD, PhD, Associate Research Scientist, Full Professor, Department of Clinical Medicine, School of Medicine, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Cidade Universitaria, Rio de Janeiro 21941-913, Brazil. hsouza@hucff.ufrj.br
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Mar 7, 2021; 27(9): 866-885 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
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