Fecal calprotectin more accurately reflects endoscopic activity of ulcerative colitis than the Lichtiger Index, CRP, or blood leukocytes
Détails
ID Serval
serval:BIB_15AAD5104A89
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Institution
Titre
Fecal calprotectin more accurately reflects endoscopic activity of ulcerative colitis than the Lichtiger Index, CRP, or blood leukocytes
Titre de la conférence
DDW 2012, Digestive Disease Week
Adresse
San Diego, California, United-States, May 20-22, 2012
ISBN
0016-5085
ISSN-L
0021-9355
Statut éditorial
Publié
Date de publication
2012
Volume
142
Série
Gastroenterology
Pages
S114
Langue
anglais
Résumé
Background: Mucosal healing in ulcerative colitis (UC) is reported to be associated with
favourable clinical outcomes such as reduced hospitalization and surgery rates. Activity
monitoring by endoscopy has its shortcomings due to invasiveness, costs, and potential
patient discomfort. Data on the correlation of noninvasive biomarkers with endoscopic
severity in UC are scarce. Aim: to evaluate the correlation between endoscopic activity
according to the modified Baron Index and fecal calprotectin, C-reactive protein (CRP),
blood leukocytes, and the Lichtiger Index (clinical score). Methods: UC patients with leftsided
and extensive colitis undergoing complete colonoscopy were prospectively enrolled
and scored clinically and endoscopically. Fecal and blood samples were analyzed in UC
patients (in a blinded fashion) and controls. The modified Baron score describes the following
5 endoscopic conditions: 0 = normal, 1 = granular mucosa, edema, 2 = friable mucosa but no
spontaneous bleeding, 3 = microulcerations with spontaneous bleeding, 4 = gross ulceration,
denuded mucosa. Results: We enrolled 228 UC patients (mean age 41 ± 13 years, 39 female)
and 52 healthy controls. Disease was located in 40% in the left colon, 21% had an extensive
and 39% a pancolitis. Endoscopic disease activity correlated best with fecal calprotectin
(Spearman's rank correlation coefficient r = 0.821), followed by the Lichtiger Index (r =
0.682), CRP (r = 0.556), and blood leukocytes (r = 0.401). Fecal calprotectin was the only
marker that could discriminate between different grades of endoscopic activity (grade 0, 25
± 11 μg/g; grade 1, 44 ± 34 μg/g; grade 2, 111 ± 74 μg/g; grade 3, 330 ± 332 μg/g; grade
4, 659 ± 319 μg/g; P = 0.002 for discriminating grade 0 vs. 1, and P < 0.001 for discriminating
grade 1 vs. 2, grade 2 vs. 3, and grade 3 vs. 4). Fecal calprotectin had the highest overall
accuracy (91%) to detect endoscopically active disease (modified Baron Index ≥ 2), followed
by the Lichtiger Index score of ≥ 4 (77%), CRP > 5 mg/L (69%) and blood leukocytosis
(58%). Conclusions: Fecal calprotectin better correlated with endoscopic disease activity
than clinical activity, CRP, and blood leukocytes. The strong correlation with endoscopic
disease activity suggests that FC represents a useful biomarker for noninvasive monitoring
of disease activity in UC patients.
favourable clinical outcomes such as reduced hospitalization and surgery rates. Activity
monitoring by endoscopy has its shortcomings due to invasiveness, costs, and potential
patient discomfort. Data on the correlation of noninvasive biomarkers with endoscopic
severity in UC are scarce. Aim: to evaluate the correlation between endoscopic activity
according to the modified Baron Index and fecal calprotectin, C-reactive protein (CRP),
blood leukocytes, and the Lichtiger Index (clinical score). Methods: UC patients with leftsided
and extensive colitis undergoing complete colonoscopy were prospectively enrolled
and scored clinically and endoscopically. Fecal and blood samples were analyzed in UC
patients (in a blinded fashion) and controls. The modified Baron score describes the following
5 endoscopic conditions: 0 = normal, 1 = granular mucosa, edema, 2 = friable mucosa but no
spontaneous bleeding, 3 = microulcerations with spontaneous bleeding, 4 = gross ulceration,
denuded mucosa. Results: We enrolled 228 UC patients (mean age 41 ± 13 years, 39 female)
and 52 healthy controls. Disease was located in 40% in the left colon, 21% had an extensive
and 39% a pancolitis. Endoscopic disease activity correlated best with fecal calprotectin
(Spearman's rank correlation coefficient r = 0.821), followed by the Lichtiger Index (r =
0.682), CRP (r = 0.556), and blood leukocytes (r = 0.401). Fecal calprotectin was the only
marker that could discriminate between different grades of endoscopic activity (grade 0, 25
± 11 μg/g; grade 1, 44 ± 34 μg/g; grade 2, 111 ± 74 μg/g; grade 3, 330 ± 332 μg/g; grade
4, 659 ± 319 μg/g; P = 0.002 for discriminating grade 0 vs. 1, and P < 0.001 for discriminating
grade 1 vs. 2, grade 2 vs. 3, and grade 3 vs. 4). Fecal calprotectin had the highest overall
accuracy (91%) to detect endoscopically active disease (modified Baron Index ≥ 2), followed
by the Lichtiger Index score of ≥ 4 (77%), CRP > 5 mg/L (69%) and blood leukocytosis
(58%). Conclusions: Fecal calprotectin better correlated with endoscopic disease activity
than clinical activity, CRP, and blood leukocytes. The strong correlation with endoscopic
disease activity suggests that FC represents a useful biomarker for noninvasive monitoring
of disease activity in UC patients.
Web of science
Création de la notice
14/02/2013 17:48
Dernière modification de la notice
20/08/2019 13:44
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