Gilles Boschetti1, Marc'harid Laidet2, Driffa Moussata2, Carmen Stefanescu3, Xavier Roblin4, Gildas Phelip2, Eddy Cotte5, Guillaume Passot5, Yves Francois5, Jocelyne Drai6, Emilie Del Tedesco4, Yoram Bouhnik3, Bernard Flourie1, Stephane Nancey1. 1. 1] Hospices Civils de Lyon, Department of Gastroenterology, Hopital Lyon-Sud, Pierre-Bénite, France [2] INSERM U1111, International Center for Research in Infectiology, Lyon, France. 2. Hospices Civils de Lyon, Department of Gastroenterology, Hopital Lyon-Sud, Pierre-Bénite, France. 3. Assistance Publique-Hôpitaux de Paris, Department of Gastroenterology, Hopital Beaujon, Paris 7 Université, Clichy, France. 4. Department of Gastroenterology, Hopital Nord, Saint-Etienne, France. 5. Hospices Civils de Lyon, Department of Digestive Surgery, Hopital Lyon-Sud, Pierre-Bénite, France. 6. Laboratory of Biochemistry, Hospices Civils de Lyon, Hopital Lyon-Sud, Pierre-Bénite, France.
Abstract
OBJECTIVES: Fecal calprotectin (fCal) is widely used as marker of gut inflammation and is strongly associated with the severity of endoscopic lesions in Crohn's disease (CD). We analyzed the relationships between levels of fCal and high-sensitivity C-reactive protein (hsCRP) and the presence and severity of postoperative endoscopic recurrence in asymptomatic CD patients (Harvey-Bradshaw index≤3). METHODS: Blood and fecal samples were collected in consecutive asymptomatic CD patients (Harvey-Bradshaw index 0.85 ± 0.19, mean ± s.e.m.) who had undergone an ileocolonic resection. hsCRP and fCal were measured and a routine ileocolonoscopy was performed within 18 months (median 7 months) from resection, to detect endoscopic recurrence according to the Rutgeerts score. RESULTS: Eighty-six patients were included in this prospective multicenter observational cohort. fCal concentrations differed significantly in patients with endoscopic recurrence when compared with those in endoscopic remission (mean ± s.e.m.: 473 ± 78 μg/g vs. 115 ± 18 μg/g; P<0.0001). The area under the receiver operating characteristic (ROC) curve to discriminate between patients in endoscopic remission and recurrence was 0.86 for fCal and lower for hsCRP (0.70). The best cutoff point for fCal to distinguish between endoscopic remission and recurrence was 100 μg/g as determined by the ROC curve, and its sensitivity, specificity, positive and negative predictive values (NPVs), as well as overall accuracy were 95%, 54%, 69%, 93%, and 77%, respectively. CONCLUSION: Measurement of fCal concentrations is a promising and useful tool for monitoring asymptomatic CD patients after ileocolonic resection. Taking into account the high NPV of fCal, a threshold below 100 μg/g could avoid systematic ileocolonoscopies in 30% of patients from this population.
OBJECTIVES: Fecal calprotectin (fCal) is widely used as marker of gut inflammation and is strongly associated with the severity of endoscopic lesions in Crohn's disease (CD). We analyzed the relationships between levels of fCal and high-sensitivity C-reactive protein (hsCRP) and the presence and severity of postoperative endoscopic recurrence in asymptomatic CDpatients (Harvey-Bradshaw index≤3). METHODS: Blood and fecal samples were collected in consecutive asymptomatic CDpatients (Harvey-Bradshaw index 0.85 ± 0.19, mean ± s.e.m.) who had undergone an ileocolonic resection. hsCRP and fCal were measured and a routine ileocolonoscopy was performed within 18 months (median 7 months) from resection, to detect endoscopic recurrence according to the Rutgeerts score. RESULTS: Eighty-six patients were included in this prospective multicenter observational cohort. fCal concentrations differed significantly in patients with endoscopic recurrence when compared with those in endoscopic remission (mean ± s.e.m.: 473 ± 78 μg/g vs. 115 ± 18 μg/g; P<0.0001). The area under the receiver operating characteristic (ROC) curve to discriminate between patients in endoscopic remission and recurrence was 0.86 for fCal and lower for hsCRP (0.70). The best cutoff point for fCal to distinguish between endoscopic remission and recurrence was 100 μg/g as determined by the ROC curve, and its sensitivity, specificity, positive and negative predictive values (NPVs), as well as overall accuracy were 95%, 54%, 69%, 93%, and 77%, respectively. CONCLUSION: Measurement of fCal concentrations is a promising and useful tool for monitoring asymptomatic CDpatients after ileocolonic resection. Taking into account the high NPV of fCal, a threshold below 100 μg/g could avoid systematic ileocolonoscopies in 30% of patients from this population.
Authors: A Orlando; I Modesto; F Castiglione; L Scala; D Scimeca; A Rispo; S Teresi; F Mocciaro; V Criscuoli; C Marrone; P Platania; T De Falco; S Maisano; N Nicoli; M Cottone Journal: Eur Rev Med Pharmacol Sci Date: 2006 Jan-Feb Impact factor: 3.507
Authors: G D Naismith; L A Smith; S J E Barry; J I Munro; S Laird; K Rankin; A J Morris; J W Winter; D R Gaya Journal: Aliment Pharmacol Ther Date: 2013-01-24 Impact factor: 8.171
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Authors: Christopher Andrew Lamb; Nicholas A Kennedy; Tim Raine; Philip Anthony Hendy; Philip J Smith; Jimmy K Limdi; Bu'Hussain Hayee; Miranda C E Lomer; Gareth C Parkes; Christian Selinger; Kevin J Barrett; R Justin Davies; Cathy Bennett; Stuart Gittens; Malcolm G Dunlop; Omar Faiz; Aileen Fraser; Vikki Garrick; Paul D Johnston; Miles Parkes; Jeremy Sanderson; Helen Terry; Daniel R Gaya; Tariq H Iqbal; Stuart A Taylor; Melissa Smith; Matthew Brookes; Richard Hansen; A Barney Hawthorne Journal: Gut Date: 2019-09-27 Impact factor: 23.059