Fecal calprotectin is a predictive marker of relapse in Crohn's disease involving the colon: a prospective study.
OBJECTIVE
Fecal calprotectin seems to have a diagnostic precision in predicting relapse in quiescent ulcerative colitis patients. However, the data remain controversial in Crohn's disease. The aim of this study was to prospectively evaluate the role of fecal calprotectin as a predictive marker for 1-year follow-up in patients with asymptomatic Crohn's disease.


METHODS
Fifty-three Crohn's disease patients in clinical remission were consecutively included providing at the beginning of the study a single stool sample as well as a blood sample and regularly followed-up for 12 months. Fecal calprotectin level was measured using a commercially available enzyme-linked immunoassay.


RESULTS
Among 53 patients, 10 (18.9%) developed clinical relapse during the 12-month follow-up period. Median fecal calprotectin level was significantly higher in relapse group patients compared with that in nonrelapse group (380.5 vs. 155 microg/g, P<0.001). With a cutoff value of 340 microg/g fecal calprotectin gave sensitivity of 80% and specificity of 90.7% in predicting clinical relapse. Fecal calprotectin level greater that 340 microg/g gave an 18-fold higher risk to develop relapse (log rank P<0.001) and was found to be an independent predictive factor of relapse (P=0.02).


CONCLUSIONS
Fecal calprotectin seems to be a reliable marker of relapse in quiescent Crohn's disease patients.
Kallel
Lamia
L
Department of Gastroenterology, Rabta Hospital, Jabbari 1007, Tunis, Tunisia. Lamia_kallel@yahoo.fr
Ayadi
Imen
I
Matri
Samira
S
Fekih
Monia
M
Mahmoud
Nadia Ben
NB
Feki
Moncef
M
Karoui
Sami
S
Zouari
Bechir
B
Boubaker
Jalel
J
Kaabachi
Naziha
N
Filali
Azza
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D016009:Chi-Square Distribution; D003106:Colon / Q000378:metabolism*; D003424:Crohn Disease / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D012074:Remission Induction; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation; D055815:Young Adult
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex