[Fecal calprotectin in differential diagnosis of irritable bowel syndrome].
OBJECTIVE
To assess the value of fecal calprotectin as a non-invasive screening biomarker in differential diagnosis of irritable bowel syndrome compared with fecal occult blood test (FOBT), erythrocyte sedimentation (ESR) or C reactive protein (CRP).


METHODS
Subjects were a total of 240 persons, including 60 patients with irritable bowel syndrome, 60 patients with colorectal cancer, 60 patients with chronic inflammation, and 60 healthy controls. 5 g fecal samples were collected within one week of endoscopy or before surgical operation. Fecal calprotectin was measured by an enzyme-linked immunosorbent assay (ELISA) kit in spot stool samples. At the same time, FOBT was measured; the results of ESR and CRP in hospital lab were collected.


RESULTS
The median of fecal calprotectin concentrations were 12.21 mg/kg and 15.36 mg/kg in IBS and healthy controls, respectively. There was no statistical significance of calprotectin concentration between patients with IBS and healthy controls (P>0.05). The median of fecal calprotectin concentrations were 159.00 mg/kg and 466.00 mg/kg in colorectal cancer and chronic inflammation respectively. There were statistical significance between patients with chronic inflammation, colorectal cancer, and others (P<0.01). The maximal calprotctin concentration was with chronic inflammation; the medium with colorectal cancer; the minimum with IBS and healthy controls. When the cut-off limit was set as 50 mg/kg of fecal calprotectin, the positive rates of colorectal cancer, chronic inflammation, IBS and healthy controls were 85.0%, 91.7%, 10%, and 5%,respectively. Fecal calprotectin was much superior to FOBT, ESR and CRP.


CONCLUSIONS
Fecal calprotectin as a non-invasive screening biomarker in the differential diagnosis of IBS and symptomatic chronic large intestinal organic disease was better than FOBT, ESR and CRP. It was simple, inexpensive, repeatable and no-invasive. It can be used as a biomarker in exclusion from related organic diseases before the diagnosis of irritable bowel syndrome.
Li
Xiao-guang
XG
Department of Gastroenterology, Peking University Third Hospital, Beijing 100083, China.
Lu
Yu-min
YM
Gu
Fang
F
Yang
Xue-ling
XL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000032:analysis; D003092:Colitis / Q000175:diagnosis; D003110:Colonic Neoplasms / Q000175:diagnosis; D003937:Diagnosis, Differential; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex