Comparison of Fecal Inflammatory Markers in Crohn's Disease.
Inflamm Bowel Dis
; 22(5): 1086-94, 2016 May.
Article
en En
| MEDLINE
| ID: mdl-26818420
ABSTRACT
BACKGROUND:
Fecal biomarkers are used increasingly to monitor Crohn's disease (CD). However, the relative accuracy of different markers in identifying inflammation has been poorly evaluated. We evaluated fecal calprotectin (FC), lactoferrin (FL), and S100A12 (FS) using endoscopic validation in a prospective study of the progression of CD after intestinal resection.METHODS:
Data were collected from 135 participants in a prospective, randomized, controlled trial aimed at preventing postoperative CD recurrence. Three hundred nineteen stool samples were tested for FC, FL, and FS preoperatively and 6, 12, and 18 months after resection. Colonoscopy was performed at 6 and/or 18 months. Endoscopic recurrence was assessed blindly using the Rutgeerts score. C-reactive protein (CRP) and Crohn's Disease Activity Index (CDAI) were assessed.RESULTS:
FC, FL, and FS concentrations were elevated preoperatively (median 1347, 40.9, and 8.4 µg/g, respectively). At 6 months postoperatively, marker concentrations decreased (166, 3.0, 0.9 µg/g) and were higher in recurrent disease than remission (275 versus 72 µg/g, P < 0.001; 5.7 versus 1.6 µg/g, P = 0.007; 2.0 versus 0.8 µg/g, P = 0.188). FC > 135 µg/g, FL > 3.4 µg/g, and FS > 10.5 µg/g indicated endoscopic recurrence (score ≥ i2) with a sensitivity, specificity, and negative predictive value (NPV) of 0.87, 0.66, and 91%; 0.70, 0.68, and 81%; 0.91, 0.12, and 71%, respectively. FC and FL correlated significantly with the presence and severity of endoscopic recurrence, whereas FS, CRP and CDAI did not.CONCLUSIONS:
FC was the optimal fecal marker for monitoring disease activity in postoperative CD and was superior to CRP and CDAI. FL offered modest sensitivity for detecting recurrent disease, whereas S100A12 was sensitive but had low specificity and NPV.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Biomarcadores
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Enfermedad de Crohn
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Mediadores de Inflamación
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Heces
/
Inflamación
Tipo de estudio:
Clinical_trials
/
Etiology_studies
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Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Inflamm Bowel Dis
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2016
Tipo del documento:
Article