Practical fecal calprotectin cut-off value for Japanese patients with ulcerative colitis

Urushikubo, Jun; Yanai, Shunichi; Nakamura, Shotaro; Kawasaki, Keisuke; Akasaka, Risaburo; Sato, Kunihiko; Toya, Yosuke; Asakura, Kensuke; Gonai, Takahiro; Sugai, Tamotsu; Matsumoto, Takayuki

doi:10.3748/wjg.v24.i38.4384

Cited by 25 publications

(28 citation statements)

References 40 publications

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“…In the studies of Theede et al histologic assessment was based on a score designed by Harpaz and Fiel which evaluated the presence/absence of cryptitis, cryptic abscesses and ulcers/erosions. In the study of Urushikubo et al histology was graded according to the scheme by Matts grade and Riley's score . Two studies defined histologic remission as the absence of epithelial neutrophils and signs of chronic inflammation.…”

Section: Resultsmentioning

confidence: 99%

“…Finally, 12 studies met the inclusion criteria and were included in the review. [13][14][15][25][26][27][28][29][30][31][32][33] The reviewers fully agreed on the selection of eligible articles. Three retrospective cohort studies [29][30][31] and nine prospective cohort studies [13][14][15][25][26][27][28]32,33 were investigated.…”

Section: Search Results and Study Populationmentioning

confidence: 99%

“…As expected, FC was reduced in case of histologic remission and was significantly increased when microscopic inflammation was found, regardless of histologic score, FC cut-off levels, and FC kit used. Seven studies 14,[25][26][27][28]30,31 used partially validated scores (Geboes score, Nancy index and Robarts histopathologic score) for histologic remission definition, while in six studies 13,15,29,32,33 histologic healing was based on nonvalidated scores. Comparative trials 31,40,41 revealed a strong correlation between Geboes score, Nancy index and Robarts score suggesting that the available validated scores may provide overlapping data.…”

Section: Discussionmentioning

confidence: 99%

“…Geboes score 35 (four studies 14,25,27 ), Nancy index 36 (two studies 28,30 ) or nonvalidated scores (five studies 13,15,29,32,33 ). One study 31 had four definitions based on three scores (Geboes score, Nancy index and Robarts histopathologic index 37 ).…”

Section: Histologic Scores and Definition Of Histologic Remissionmentioning

confidence: 99%

“…27 One study 31 analysis. [13][14][15][25][26][27][28][29][30][31][32][33] Seven studies 13,14,27,29,30,32,33 31 In the individual studies microscopic inflammation was found in a percentage of patients ranging from 11.6% to 57.1%, although they were considered in disease remission. Several FC cut-off points were found to predict the presence or absence of histologic activity with a high degree of accuracy.…”

Section: Correlation Between Faecal Calprotectin Levels and Histologymentioning

confidence: 99%

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Review article: faecal calprotectin and histologic remission in ulcerative colitis

D’Amico

Bonovas

Danese

et al. 2020

Aliment Pharmacol Ther

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Summary Background Histologic healing is emerging as a new therapeutic goal in both routine practice and clinical trials in ulcerative colitis (UC). However, it requires repeated endoscopies and biopsies. Faecal calprotectin is a non‐invasive marker of mucosal healing (endoscopic and histologic healing). Aim To conduct a systematic review to clarify the correlation between faecal calprotectin levels and histologic activity in UC patients. Methods We searched PubMed/MEDLINE, EMBASE and Web of Science through September 2019 to identify studies in patients with confirmed diagnosis of UC, reporting the correlation between faecal calprotectin levels and histologic analysis. Results Twelve studies enrolling 1168 patients were included in the final review. Histologic remission was defined according to nonvalidated scores in five articles and using partially validated scores in seven articles. Faecal calprotectin values were measured in 6 of 12 studies (50%) with the same kit, while the remaining six studies adopted individually different kits. A clear correlation between faecal calprotectin levels and histology was showed in all included studies. Eleven different faecal calprotectin cut‐off points were identified to distinguish histological remission from histological activity, ranging from 40.5 to 250 μg/g. Conclusions Faecal calprotectin can be used to predict histologic remission in patients with UC, but the cut‐off level varies across studies, according to the test used to measure this biomarker and according to the definition of histologic remission. Larger prospective studies using validated histologic indexes are needed to identify a globally accepted faecal calprotectin cut‐off level to discriminate between histologic remission and histologically active disease.

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Section: Resultsmentioning

confidence: 99%

Section: Search Results and Study Populationmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Histologic Scores and Definition Of Histologic Remissionmentioning

confidence: 99%

Section: Correlation Between Faecal Calprotectin Levels and Histologymentioning

confidence: 99%

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Review article: faecal calprotectin and histologic remission in ulcerative colitis

D’Amico

Bonovas

Danese

et al. 2020

Aliment Pharmacol Ther

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Diagnostic accuracy of multimodal noninvasive follow‐up for pediatric ulcerative colitis: A single‐center prospective study

Spyropoulou,

Russo,

Rossi

et al. 2023

J. pediatr. gastroenterol. nutr.

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ObjectivesUlcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) often requiring endoscopic evaluations, which can be uncomfortable and costly, especially for children. This study aimed to evaluate the diagnostic accuracy of a noninvasive approach combining fecal calprotectin (FCP), colonic ultrasonography (US), and colon capsule endoscopy (CCE) compared with standard ileocolonoscopy in pediatric UC.MethodsUC children were enrolled and underwent FCP and US on Day 0, followed by CCE on Day 1 and ileocolonoscopy on Day 2. All procedures were performed by operators who were blinded to the patient's clinical history and all test results. The accuracy for disease activity and extension of each technique and their combination was assessed and compared. Tolerability and safety were also evaluated.ResultsThirty‐two patients were enrolled (15 males, mean age 13.2 ± 3.2 years). CCE showed a sensitivity of 95% and specificity of 100% in detecting colonic inflammation, with positive predictive value (PPV) and negative predictive value (NPV) of 100% and 92%, respectively. US demonstrated a sensitivity of 85% and specificity of 92%, with PPV and NPV of 94% and 79%. The combination of FCP, US, and CCE achieved 95% sensitivity and 100% specificity, with PPV of 100% and NPV of 92%. The noninvasive approach was better tolerated than colonoscopy (p < 0.05), and no serious adverse events were reported.ConclusionThe noninvasive approach combining fecal calprotectin (FCP), ultrasonography, and colon capsule endoscopy demonstrated high diagnostic accuracy and better tolerability compared with standard ileocolonoscopy in pediatric ulcerative colitis follow‐up. Further multicenter studies are needed to confirm these findings and evaluate the reproducibility of this noninvasive approach.

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Further research on the clinical relevance of the ulcerative colitis colonoscopic index of severity for predicting 5-year relapse

Ishida

Onoue

Miyazu

et al. 2021

Int J Colorectal Dis

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Purpose The ulcerative colitis colonoscopic index of severity (UCCIS) evaluates the state of the entire colonic mucosa in ulcerative colitis. However, no cut-off values of scores for predicting clinical relapse in patients with ulcerative colitis have been established. This study aimed to determine the cut-off values for predicting clinical relapse in patients with ulcerative colitis. Methods The endoscopic scores (sum of Mayo endoscopic subscores (S-MES) and UCCIS) of 157 patients with ulcerative colitis experiencing clinical remission and their subsequent clinical course were retrospectively reviewed. The optimal cut-off values for predicting relapse and relapse-free rates were analyzed by receiver operating characteristic analysis. Results Forty patients with ulcerative colitis experienced relapse within 24 months. The median UCCIS for these patients at the time of study enrollment was significantly higher than that for patients with clinical remission (P < 0.001). The cut-off value of the UCCIS for predicting relapse was 9.8. The relapse-free rate was significantly lower in patients with UCCIS ≥ 9.8 than in those with UCCIS < 9.8 (log-rank test P < 0.001). For patients who experienced relapse within 5 years, the optimal cut-off values for the UCCIS and S-MES were 10.2 and 1, respectively (P = 0.004). Conclusions The data from this study indicate that the USSIC is a more relevant score than the S-MES for predicting the time to relapse in patients with ulcerative colitis in remission.

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Practical fecal calprotectin cut-off value for Japanese patients with ulcerative colitis

Cited by 25 publications

References 40 publications

Review article: faecal calprotectin and histologic remission in ulcerative colitis

Review article: faecal calprotectin and histologic remission in ulcerative colitis

Diagnostic accuracy of multimodal noninvasive follow‐up for pediatric ulcerative colitis: A single‐center prospective study

Further research on the clinical relevance of the ulcerative colitis colonoscopic index of severity for predicting 5-year relapse

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