Advances in fecal biomarkers for necrotizing enterocolitis

Abstract. Necrotizing enterocolitis (NEC) is a serious gastrointestinal disease in neonatal period. Early identification and early intervention are of great significance to improve the prognosis of children. At present, the diagnosis of NEC mainly depends on clinical manifestations, laboratory indicators and abdominal imaging examinations. However, the early symptoms lack specificity, and the blood test has certain trauma. The typical imaging signs suggest that the disease progresses to the middle and late stages, and there is a certain lag. In recent years, with the deepening of the research on the pathogenesis and detection technology of NEC, fecal markers have attracted attention because they may reflect pathological changes within the intestinal lumen and support early prediction, diagnosis, severity assessment, and prognostic evaluation of NEC. Existing studies have shown that fecal inflammatory proteins, barrier and mucosal injury-related indicators, intestinal flora and metabolic indicators can change during the development of NEC, which may support early prediction, diagnosis, severity assessment and prognostic prediction of NEC. Based on the main pathological processes of NEC, this review summarizes the research progress and current limitations of fecal biomarkers and discusses their potential clinical applications in NEC.