Diagnostic value of faecal calprotectin in unselected outpatients referred for colonoscopy: A multicenter prospective study.
OBJECTIVE
To evaluate the role of faecal calprotectin in consecutive outpatients referred for colonoscopy.


METHODS
Outpatients undergoing colonoscopy at five participating institutions were eligible. Demographic and clinical data were collected. Faecal samples were tested at a single laboratory by means of a commercially available kit.


RESULTS
We consecutively enrolled 870 patients. Mean levels of calprotectin were significantly higher in patients with neoplastic and inflammatory disorders when compared with subjects with a normal colonoscopy or trivial endoscopic findings. Elevated calprotectin levels (>50mg/dl) were detected in 85% of patients with colorectal cancer, and 81% of those with inflammatory conditions but also in 37% of patients with normal or trivial endoscopic findings. In patients referred for chronic diarrhoea, sensitivity and negative predictive value were 100% in detecting either any organic colonic disease. In patients referred for symptoms of "suspected functional origin" sensitivity and negative predictive value for colorectal cancer were also 100%.


CONCLUSIONS
In unselected outpatients referred for colonoscopy, a single measurement of faecal calprotectin is not sufficiently accurate to identify those with significant colorectal disease. However, a normal result can help rule out organic disease among patients with diarrhoea and those with abdominal pain and/or constipation.
Meucci
Gianmichele
G
Valduce Hospital, Como, Italy. g.meucci@tele2.it
D'Incà
Renata
R
Maieron
Roberto
R
Orzes
Nicoletta
N
Vecchi
Maurizio
M
Visentini
Daniela
D
Minoli
Giorgio
G
Dal Pont
Elisabetta
E
Zilli
Maurizio
M
Benedetti
Elvio
E
Virgilio
Tiziana
T
Tonutti
Elio
E
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003248:Constipation / Q000209:etiology; D003967:Diarrhea / Q000209:etiology; D005243:Feces / Q000737:chemistry*; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis*; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011237:Predictive Value of Tests; D011446:Prospective Studies; D055815:Young Adult
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex