Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohn’s disease with fecal calprotectin

Abstract

Background: Fecal biomarkers, especially fecal calprotectin, are useful for predicting endoscopic activity in Crohn's disease; however, the cut-off point remains unclear. The aim of this paper was to analyze whether faecal calprotectin and M2 pyruvate kinase are good tools for generating highly accurate scores for the prediction of the state of endoscopic activity and mucosal healing.Methods: The simple endoscopic score for Crohn's disease and the Crohn's disease activity index was calculated for 71 patients diagnosed with Crohn's. Fecal calprotectin and M2-PK were measured by the enzyme-linked immunosorbent assay test.Results: A fecal calprotectin cut-off concentration of ≥ 170 µg/g (sensitivity 77.6%, specificity 95.5% and likelihood ratio +17.06) predicts a high probability of endoscopic activity, and a fecal calprotectin cut-off of ≤ 71 µg/g (sensitivity 95.9%, specificity 52.3% and likelihood ratio -0.08) predicts a high probability of mucosal healing. Three clinical groups were identified according to the data obtained: endoscopic activity (calprotectin ≥ 170), mucosal healing (calprotectin ≤ 71) and uncertainty (71 > calprotectin < 170), with significant differences in endoscopic values (F = 26.407, p < 0.01). Clinical activity or remission modified the probabilities of presenting endoscopic activity (100% vs 89%) or mucosal healing (75% vs 87%) in the diagnostic scores generated. M2-PK was insufficiently accurate to determine scores.Conclusions: The highly accurate scores for fecal calprotectin provide a useful tool for interpreting the probabilities of presenting endoscopic activity or mucosal healing, and are valuable in the specific clinical context.

Vitamin D deficiency in outpatients with inflammatory bowel disease: prevalence and association with clinical-biological activity

“…Samples with values > 500 mcg/g were subsequently diluted to obtain values above 1,000 mcg/g. In agreement with a recent study from our latitude and using the same FC commercial technique (18), 170 mcg/g was used as the cut point to differentiate between the biological viewpoint and active disease and remission. Quality of life was measured using the Spanish version of the Short Quality of Life in Inflammatory Bowel Disease Questionnaire (SIBDQ-9).…”

From bench to bedside: Fecal calprotectin in inflammatory bowel diseases clinical setting

“…In CD, FC concentration of ≥ 170 μg/g predicted endoscopic activity with 77.6% sensitivity, 95.5% specificity and likelihood ratio +17.06, while values ≤ 71 μg/g were predictive of mucosal healing with sensitivity of 95.9%, specificity of 52.3% and likelihood ratio -0.08[ 31 ].…”

Correlation between Clinical Symptoms and Lab Tests with Endoscopic Severity Indexes in Patients with Inflammatory Bowel Diseases

“…Furthermore, fecal calprotectin has been shown to have a significant association with mucosal healing in patients with IBD, and a cut-off of ≤ 71 µg/g (with a sensitivity of 95.9% and specificity of 52.3%) could be used as a reliable tool for evaluating mucosal healing. 39 , 40 It should be noted that a recent study showed a better diagnostic accuracy for fecal calprotectin in UC compared with CD. 41 …”