Year 2017 / Volume 109 / Number 2
Original
Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohn’s disease with fecal calprotectin

130-136

DOI: 10.17235/reed.2017.4542/2016

Juan María Vázquez Morón, Héctor Pallarés Manrique, Francisco H. Machancoses, Manuel Ramos Lora, Carlos Ruiz Frutos,

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.
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Vázquez Morón J, Pallarés Manrique H, Machancoses F, Ramos Lora M, Ruiz Frutos C. Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohn’s disease with fecal calprotectin. 4542/2016


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Publication history

Received: 14/07/2016

Accepted: 29/10/2016

Online First: 10/01/2017

Published: 31/01/2017

Article revision time: 94 days

Article Online First time: 180 days

Article editing time: 201 days


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