title: Fecal calprotectin more accurately reflects endoscopic activity of ulcerative colitis than the Lichtiger Index, C-reactive protein, platelets, hemoglobin, and blood leukocytes.
abstract: BACKGROUND
  The correlation between noninvasive markers with endoscopic activity according to the modified Baron Index in patients with ulcerative colitis (UC) is unknown. We aimed to evaluate the correlation between endoscopic activity and fecal calprotectin (FC), C-reactive protein (CRP), hemoglobin, platelets, blood leukocytes, and the Lichtiger Index (clinical score).
  
  
  METHODS
  UC patients undergoing complete colonoscopy were prospectively enrolled and scored clinically and endoscopically. Samples from feces and blood were analyzed in UC patients and controls.
  
  
  RESULTS
  We enrolled 228 UC patients and 52 healthy controls. Endoscopic disease activity correlated best with FC (Spearman's rank correlation coefficient r = 0.821), followed by the Lichtiger Index (r = 0.682), CRP (r = 0.556), platelets (r = 0.488), blood leukocytes (r = 0.401), and hemoglobin (r = -0.388). FC was the only marker that could discriminate between different grades of endoscopic activity (grade 0, 16 [10-30] μg/g; grade 1, 35 [25-48] μg/g; grade 2, 102 [44-159] μg/g; grade 3, 235 [176-319] μg/g; grade 4, 611 [406-868] μg/g; P < 0.001 for discriminating the different grades). FC with a cutoff of 57 μg/g had a sensitivity of 91% and a specificity of 90% to detect endoscopically active disease (modified Baron Index ≥ 2).
  
  
  CONCLUSIONS
  FC correlated better with endoscopic disease activity than clinical activity, CRP, platelets, hemoglobin, and blood leukocytes. The strong correlation with endoscopic disease activity suggests that FC represents a useful biomarker for noninvasive monitoring of disease activity in UC patients.
authors: Department of Gastroenterology and Hepatology, University Hospital Lausanne/CHUV, Switzerland. alain.schoepfer@chuv.ch
authors: Alain M
authors: AM
authors: Schoepfer
authors: Christoph
authors: C
authors: Beglinger
authors: Alex
authors: A
authors: Straumann
authors: Ekaterina
authors: E
authors: Safroneeva
authors: Yvonne
authors: Y
authors: Romero
authors: David
authors: D
authors: Armstrong
authors: Carsten
authors: C
authors: Schmidt
authors: Michael
authors: M
authors: Trummler
authors: Valérie
authors: V
authors: Pittet
authors: Stephan R
authors: SR
authors: Vavricka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000097:blood / Q000175:diagnosis* / Q000378:metabolism; D003113:Colonoscopy; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000737:chemistry*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007958:Leukocyte Count; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D039841:Leukocyte L1 Antigen Complex; D002097:C-Reactive Protein