title: Accuracy of advanced endoscopy and fecal calprotectin for prediction of relapse in ulcerative colitis: a prospective study.
abstract: BACKGROUND
  The aim of this study was to determine the accuracy of advanced endoscopy for prediction of relapse in ulcerative colitis, in comparison with serum and fecal biomarkers.
  
  
  METHODS
  Patients with ulcerative colitis with sustained clinical remission defined as absence of blood in stool for a minimum of 3 months and Mayo endoscopic subscore of 0 were included. High-resolution rectosigmoidoscopy was performed at baseline and at the end of study (week 52 or relapse), assessing mucosal pit pattern by chromoendoscopy and narrow band imaging as well as vascular pattern by narrow band imaging. Histology was evaluated at baseline and at the end of the study. Follow-up for 1 year or until relapse with clinical evaluations and serum and fecal biomarkers every 3 months was established. Relapse was defined as presence of blood in stool and a Mayo endoscopic subscore ≥1 with histologic confirmation.
  
  
  RESULTS
  Seventeen out of 64 patients (27%) relapsed during the follow-up period. Baseline clinical characteristics in patients who relapsed and those who did not were similar. Neither pit or vascular pattern nor histology was significantly different between relapsers and nonrelapsers. Among serum biomarkers, high platelet count was significantly associated with higher relapse rates. Fecal calprotectin was predictor of relapse within 3- and 12-month period with high specificity but low sensitivity.
  
  
  CONCLUSIONS
  Advanced endoscopy and histology do not predict relapse over 1-year period in patients with ulcerative colitis. Fecal calprotectin can predict relapse in 3- and 12-month period with low accuracy.
authors.affiliation: *Department of Gastroenterology, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; and †Department of Pathology, Hospital Clínic de Barcelona, Barcelona, Spain.
authors.forename: Aranzazu
authors.initials: A
authors.lastname: Jauregui-Amezaga
authors.forename: María
authors.initials: M
authors.lastname: López-Cerón
authors.forename: Montserrat
authors.initials: M
authors.lastname: Aceituno
authors.forename: Mireya
authors.initials: M
authors.lastname: Jimeno
authors.forename: Cristina
authors.initials: C
authors.lastname: Rodríguez de Miguel
authors.forename: Susana
authors.initials: S
authors.lastname: Pinó-Donnay
authors.forename: Michel
authors.initials: M
authors.lastname: Zabalza
authors.forename: Miquel
authors.initials: M
authors.lastname: Sans
authors.forename: Elena
authors.initials: E
authors.lastname: Ricart
authors.forename: Ingrid
authors.initials: I
authors.lastname: Ordás
authors.forename: Begoña
authors.initials: B
authors.lastname: González-Suárez
authors.forename: Miriam
authors.initials: M
authors.lastname: Cuatrecasas
authors.forename: Josep
authors.initials: J
authors.lastname: Llach
authors.forename: Julian
authors.initials: J
authors.lastname: Panés
authors.forename: María
authors.initials: M
authors.lastname: Pellise
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D003113:Colonoscopy / Q000379:methods*; D005243:Feces / Q000737:chemistry*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012812:Sigmoidoscopy / Q000379:methods; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex