Diagnostic accuracy of fecal lactoferrin for inflammatory bowel disease: a meta-analysis.

ABSTRACT

OBJECTIVE: To do a systematic review using meta-analysis to assess the diagnostic accuracy of fecal lactoferrin (FL) in patients with inflammatory bowel disease (IBD). METHODS: We performed a literature review and systematically searched the Medline and EMBASE databases for eligible studies. The quality of the included studies was assessed using the QUADAS tool. The sensitivity, specificity, and other diagnostic indexes of FL were pooled using a random-effects model. RESULTS: Seven studies, involving 1816 patients, met the inclusion criteria. In all studies, the pooled FL sensitivity and pooled specificity were 0.82 (95% confidence interval [CI] 0.72, 0.89) and 0.95 (95% CI 0.88, 0.98), respectively. The positive and negative likelihood ratios were 16.63 and 0.18, respectively. The area under the summary receiver-operating characteristic curve (SROC) was 0.95 (95% CI 0.93, 0.97), and the diagnostic odds ratio was 90.04 (95% CI 37.01, 219.02). The pooled FL sensitivity and specificity for Crohn's disease (CD) diagnosis (sensitivity =75%, specificity =100%) was not as good as it was for ulcerative colitis (UC) diagnosis (sensitivity =82%, specificity =100%). CONCLUSION: FL, as a noninvasive and screening marker, has a high specificity and a modest specificity during the diagnosis of suspected IBD.