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Dig Dis Sci. 2018 May;63(5):1294-1301. doi: 10.1007/s10620-018-4980-0. Epub 2018 Feb 22.

Fecal Calprotectin in Assessing Endoscopic and Histological Remission in Patients with Ulcerative Colitis.

Author information

1
Inflammatory Bowel Disease Center, University of Chicago Medicine, 5841 S. Maryland Ave. | MC4076|, Chicago, IL, 60637, USA.
2
Department of Medicine, Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong.
3
Inserm, CHU Clermont-Ferrand, 3iHP, Service d'Hépato-Gastro Entérologie, Université Clermont Auvergne, Clermont-Ferrand, France.
4
3iHP, Inserm U1071, M2iSH, USC-INRA 2018, Université Clermont Auvergne, 63000, Clermont-Ferrand, France.
5
CHU Clermont-Ferrand, DRCI, Unité de Biostatistiques, Université Clermont Auvergne, Clermont-Ferrand, France.
6
Inflammatory Bowel Disease Center, University of Chicago Medicine, 5841 S. Maryland Ave. | MC4076|, Chicago, IL, 60637, USA. drubin@medicine.bsd.uchicago.edu.

Abstract

BACKGROUND:

Persistent active endoscopic and histological inflammation is associated with poorer outcomes in ulcerative colitis (UC). Fecal calprotectin is a surrogate marker of endoscopic and histological remission.

AIMS:

To confirm the correlation between fecal calprotectin and endoscopic or histological disease activity and to define the optimal cutoff value to detect endoscopic and histological remission.

METHODS:

From a prospectively maintained database, we analyzed 61 UC patients who had fecal calprotectin measurement and endoscopy performed within 1 month. Endoscopic activity was graded using the Mayo endoscopic subscore (MES). Histological remission was defined as normal histology or quiescent histological activity.

RESULTS:

Eighteen patients (29.5%) and five patients (8.1%) had endoscopic remission defined as MES ≤ 1 or MES = 0, respectively. We observed a significantly lower median level of fecal calprotectin in patients with endoscopic remission than those with endoscopic activity for both definition of endoscopic remission, i.e., MES ≤ 1 (158 vs 490 µg/g, p = 0.0005) or MES = 0 (94 vs 414 µg/g, p = 0.013). Seven patients (11.5%) were in histological remission. They had a lower median level of fecal calprotectin than those with active histological inflammation (107 vs 416 µg/g, p = 0.016). Using a ROC curve, fecal calprotectin < 250 µg/g predicted endoscopic remission (MES ≤ 1) with a sensitivity of 67% and specificity of 77%, while fecal calprotectin < 200 µg/g predicted histological remission with a sensitivity of 71% and specificity of 76%.

CONCLUSION:

Fecal calprotectin level correlated with both endoscopic activity and histological activity and is a reliable biomarker in assessing mucosal healing in UC.

KEYWORDS:

Endoscopic remission; Fecal calprotectin; Histological remission; Mucosal healing; Ulcerative colitis

PMID:
29468374
DOI:
10.1007/s10620-018-4980-0
[Indexed for MEDLINE]

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