title: Diagnostic value of faecal calprotectin in unselected outpatients referred for colonoscopy: A multicenter prospective study.
abstract: 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.
authors.affiliation: Valduce Hospital, Como, Italy. g.meucci@tele2.it
authors.forename: Gianmichele
authors.initials: G
authors.lastname: Meucci
authors.forename: Renata
authors.initials: R
authors.lastname: D'Incà
authors.forename: Roberto
authors.initials: R
authors.lastname: Maieron
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Orzes
authors.forename: Maurizio
authors.initials: M
authors.lastname: Vecchi
authors.forename: Daniela
authors.initials: D
authors.lastname: Visentini
authors.forename: Giorgio
authors.initials: G
authors.lastname: Minoli
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Dal Pont
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zilli
authors.forename: Elvio
authors.initials: E
authors.lastname: Benedetti
authors.forename: Tiziana
authors.initials: T
authors.lastname: Virgilio
authors.forename: Elio
authors.initials: E
authors.lastname: Tonutti
mesh_terms: 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
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex