title: Diagnostic value of fecal calprotectin as a screening biomarker for gastrointestinal malignancies.
abstract: BACKGROUND
  Calprotectin in feces seems to be a more sensitive marker for gastrointestinal (GI) cancers than fecal occult blood, but its specificity may be too low for screening average risk populations. This study aims at evaluating the diagnostic value of fecal calprotectin as a screening biomarker for GI malignancies.
  
  
  METHODS
  In a case-control study, 100 patients with GI malignancies (50 patients with colorectal cancer and 50 patients with gastric cancer) and 50 controls were recruited in Tabriz Imam Reza and Sina hospitals during a 24-month period. One to two weeks after the last endoscopy/colonoscopy, fecal specimens were collected by the patients and examined by ELISA method for quantitative measurement of calprotectin content. The results were compared between the three groups.
  
  
  RESULTS
  The mean fecal calprotectin level was 109.1 ± 105.3 (2.3-454.3, median:74), 241.1 ± 205.2 (3.4-610.0, median:19.3) and 45.9 ± 55.1 μg/g (1.3-257.1, median:19.3) in gastric cancer, colorectal cancer and control group, respectively, the differences being significant (p<0.001) and remaining after adjustment for age. The optimal cut-off point for fecal calprotectin was ≥ 75.8 μg/g for distinguishing colorectal cancer from normal cases (sensitivity and specificity of 80% and 84%, respectively). This value was ≥ 41.9 μg/g for distinguishing gastric cancer from normal cases (sensitivity and specificity of 62%).
  
  
  CONCLUSIONS
  Our results revealed that fecal calprotectin might be a useful and non-invasive biomarker for distinguishing colorectal cancer from non-malignant GI conditions. However, due to low sensitivity and specificity, this biomarker may not help physicians distinguishing gastric cancer cases from healthy subjects.
authors.affiliation: Liver and Gastroentestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran E-mail : mkhoshbaten@yahoo.com.
authors.forename: Manouchehr
authors.initials: M
authors.lastname: Khoshbaten
authors.forename: Parinaz
authors.initials: P
authors.lastname: Pishahang
authors.forename: Mohammad
authors.initials: M
authors.lastname: Nouri
authors.forename: Alireza
authors.initials: A
authors.lastname: Lashkari
authors.forename: Mahasti
authors.initials: M
authors.lastname: Alizadeh
authors.forename: Mohammad
authors.initials: M
authors.lastname: Rostami-Nejad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis*
chemical_list: D014408:Biomarkers, Tumor; D039841:Leukocyte L1 Antigen Complex