[Diagnostic value of fecal calprotectin in predicting an abnormal colonoscopy].
OBJECTIVE
Abdominal pain and diarrhoea are common symptoms in the general population. The colonoscopy is the gold standard method of detecting an organic pathology in the colon. However, it is invasive; it can not be repeated frecuently; it is expensive; and the system is overloaded. Fecal calprotectin (FCP) is a marker that may detect organic pathologies of the colon. The aims of this study were to analyze the usefulness of FCP to predict an abnormal colonoscopy and to correlate the levels of FCP with the degree of activity in inflammatory bowel disease (IBD).


METHODS
190 people were included in the study. All of them underwent a colonoscopy and a stool sample. People were divided in: normal colonoscopy: 117 people, and 28 colon adenomas, 20 colorectal cancer (CRC) and 25 IBD.


RESULTS
The mean (SD) FCP concentration was 2,171.1 (2,133.6) mg/kgin patients with IBD and 726.6 mg/kg (533) in CRC. Both results were significantly elevated compared with those of healthy controls [114 (113)] mg/kg In patients with IBD, their levels correlated directly with the activity of the inflammation. 217 mg/kg was the best cut-off for discriminating patients with organic colon disorders. The sensibility was 85% and NPV was 93%. NSAIDs use was a clinical variable which was connected with a high FCP concentration in patients with normal colonoscopy.


CONCLUSIONS
The higher levels of FCP were found in people with IBD and CRC. The measurement of FCP is a non-invasive, inexpensive, reliable and easily measured test. Among people with abdominal pain and diarrhoea, testing for FCP allows us to select those who must undergo a colonoscopy. NSAIDs can raise the levels of FCP in people with normal colonoscopies.
García Sánchez
María del Valle
Mdel V
Unidad Clínica Aparato Digestivo, Hospital Universitario Reina Sofía, Avda. Menéndez Pilal s/n, 14004 Córdoba, Spain. vallegarcia@supercable.es
González
Raúl
R
Iglesias Flores
Eva
E
Gómez Camacho
Federico
F
Casais Juanena
Luis
L
Cerezo Ruiz
Antonio
A
Montero Pérez-Barquero
Manuel
M
Muntané
Jordi
J
de Dios Vega
Juan Francisco
JF
D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000175:diagnosis*; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003113:Colonoscopy; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies
D039841:Leukocyte L1 Antigen Complex