title: The diagnostic usefulness of fecal lactoferrin in the assessment of Crohn's disease activity.
abstract: BACKGROUND
  Diagnosis and monitoring of Crohn's disease (CD) is difficult and time-consuming. In recent years, diagnostic usefulness of fecal calprotectin has been proven. However, data on the utility of other fecal markers are scarce.
  
  
  OBJECTIVE
  To evaluate the usefulness of fecal lactoferrin (FL) in the assessment of CD activity.
  
  
  METHODS
  The group consisted of 101 CD patients (median age: 30 years, IQR: 24-37). FL was measured in a single stool sample by using the immunoenzymatic methods. The clinical activity of the disease was evaluated by using the Crohn's Disease Activity Index (CDAI). Depending on the location of the disease, either a colonoscopy or magnetic resonance enterography was performed or both in order to evaluate the disease activity by using appropriate endoscopic and enterographic scores.
  
  
  RESULTS
  Median FL concentration was 84.14 (IQR: 36.4-302.9) μg/ml and it correlated with C-reactive protein concentration (p=0.0000001, r=0.5), CDAI (p=0.002, r=0.3) and colonic Simple Endoscopic Score for Crohn's Disease (SES-CD) (p=0.000004, r=0.5). Assuming endoscopic remission in the large intestine with colonic SES-CD≤3 points, a ROC curve showed that FL concentration of 145.82 μg/ml had 84.6% sensitivity and 60.5% specificity in discriminating CD patients with endoscopically active and inactive disease [AUC: 0.676 (95% CI: 0.531-0.8), (p=0.0347)]. The positive predictive value for this concentration was 42% and negative predictive value -92%.
  
  
  CONCLUSIONS
  FL is a sensitive marker of CD activity and it reliably reflects the mucosal inflammatory lesions in large intestine. Thus, it can be helpful in diagnostics and monitoring of CD.
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Clinical Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Klimczak
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Clinical Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Liliana
authors.initials: L
authors.lastname: Lykowska-Szuber
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Clinical Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland. Electronic address: piotr.eder@op.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Eder
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Clinical Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Krela-Kazmierczak
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Clinical Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Kamila
authors.initials: K
authors.lastname: Stawczyk-Eder
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Clinical Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Szymczak
authors.affiliation: Department of Computer Science and Statistics, Poznan University of Medical Sciences, Dabrowskiego Street 79, 60-529, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Michalak
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Clinical Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Studniarek
authors.affiliation: Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Clinical Hospital, Przybyszewskiego Street 49, 60-355 Poznan, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Linke
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000032:analysis; D003106:Colon / Q000473:pathology; D003424:Crohn Disease / Q000175:diagnosis* / Q000473:pathology; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007781:Lactoferrin / Q000032:analysis*; D008297:Male; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007781:Lactoferrin
keywords: Colonoscopy; Crohn's disease; Fecal markers; Lactoferrin; Mucosal healing