Fecal Immunochemical Test Versus Fecal Calprotectin for Prediction of Mucosal Healing in Crohnʼs Disease

Inokuchi, Toshihiro; Kato, Jun; Hiraoka, Sakiko; Takashima, Seisuke; Nakarai, Asuka; Takei, Daisuke; Sugihara, Yuusaku; Takahara, Masakazu; Kawano, Seiji; Harada, Kensuke; Okada, Hiroyuki

doi:10.1097/mib.0000000000000728

Cited by 52 publications

(30 citation statements)

References 33 publications

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“… 38 However, in patients with CD, faecal haemoglobin was less sensitive for reflecting CD lesions in the small bowel compared with calprotectin. 9 Likewise, in our study, we found that the diagnostic value (specificity, PPV, NPV and AUC) of faecal haemoglobin for small bowel inflammation was much lower than calprotectin or lactoferrin. These findings might suggest that FIT is more suitable for the detection of blood in the colon and rectum, and should be mainly used for screening large bowl inflammation in IBD patients.…”

Section: Discussionsupporting

confidence: 63%

“… 8 , 9 , 38 FIT has several advantages over faecal calprotectin testing in terms of user-friendliness, lower cost, simplicity, clean handling and the ability to carry out rapid assays by using an automated measurement system. 8 , 9 , 38 A direct comparison between the value of faecal calprotectin and haemoglobin indicated that both biomarkers are equally useful for the assessment of mucosal inflammation in patients with UC. 38 However, in patients with CD, faecal haemoglobin was less sensitive for reflecting CD lesions in the small bowel compared with calprotectin.…”

Section: Discussionmentioning

confidence: 99%

“… 3 – 7 Faecal immunochemical test (FIT) for the detection of haemoglobin in the stool has been widely used in colorectal cancer screening, but it is currently being adopted for monitoring intestinal inflammation in IBD patients. 8 , 9 These biomarkers are simple, convenient and low cost to assay, and can serve as non-invasive tests to assess intestinal inflammation. 3 – 9 …”

Section: Introductionmentioning

confidence: 99%

“… 8 , 9 These biomarkers are simple, convenient and low cost to assay, and can serve as non-invasive tests to assess intestinal inflammation. 3 – 9 …”

Section: Introductionmentioning

confidence: 99%

“…Several studies 8 – 15 and a meta-analysis 16 found that faecal calprotectin, lactoferrin and haemoglobin were relevant biomarkers in identifying mucosal inflammation in patients with IBD, which is confined mainly to the large intestine. Therefore, these biomarkers appeared to have greater utility to replace endoscopic activity in ulcerative colitis (UC) than in Crohn’s disease (CD) patients.…”

Section: Introductionmentioning

confidence: 99%

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Faecal biomarkers for screening small bowel inflammation in patients with Crohn’s disease: a prospective study

Shimoyama

Yamamoto

Umegae

et al. 2017

Therap Adv Gastroenterol

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Background:The value of faecal biomarkers for screening small bowel inflammation in patients with Crohn’s disease (CD) remains to be elucidated. This prospective study was to evaluate the utility of faecal biomarkers for detecting small intestinal inflammation.Methods:A total of 122 consecutive patients with a diagnosis of CD in the small intestine were screened for eligibility. Computed tomography enterography (CTE) was undertaken to evaluate small bowel inflammation followed by colonoscopy to confirm no large bowel involvement. Seventy eligible patients with inflammation confined to the small intestine were included. Faecal samples were collected for assaying calprotectin, lactoferrin and haemoglobin. For assessing the degree of small bowel inflammation, a semi-quantitative scoring system (CTE0, normal; CTE1, mild; CTE2, moderate; CTE3, severe) was applied.Results:The median calprotectin, lactoferrin and haemoglobin levels were significantly higher in patients with small bowel inflammation, CTE scores 1–3 (n = 42) versus 0 (n = 28): calprotectin, 330 versus 40 ng/ml, p < 0.0001; lactoferrin, 14 versus 3 ng/ml, p < 0.0001; haemoglobin, 29.5 versus 6.5 ng/ml, p = 0.005. There was a strong positive relationship between the faecal biomarkers and CTE score: calprotectin, p < 0.0001; lactoferrin, p < 0.0001; haemoglobin, p = 0.0004. A cutoff value of 140 ng/ml for calprotectin had a sensitivity of 69% and a specificity of 82% with an area under the receiver operating characteristic curve (AUC) of 0.82 to detect small bowel inflammation (CTE scores 1–3), while lactoferrin 6 ng/ml had a sensitivity of 69% and a specificity of 79% with an AUC of 0.83, and haemoglobin 9 ng/ml showed a sensitivity of 71% and a specificity of 39% with an AUC of 0.70.Conclusions:Faecal calprotectin, lactoferrin, and to a lesser degree haemoglobin are relevant biomarkers for screening small bowel inflammation in CD patients without large bowel involvement. Further well-designed large-scale studies in this clinical setting should strengthen our findings.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“… 8 , 9 These biomarkers are simple, convenient and low cost to assay, and can serve as non-invasive tests to assess intestinal inflammation. 3 – 9 …”

Section: Introductionmentioning

confidence: 99%