title: The utility of faecal calprotectin to predict post-operative recurrence in Crohńs disease.
abstract: OBJECTIVE
  Endoscopic recurrence in Crohńs disease occurs in up to 80% of patients during the first year after surgery. Due to this, these patients need close monitoring. Faecal calprotectin has been proposed to be used as a non-invasive marker to monitor inflammatory activity. Up to now the use of faecal markers in endoscopic recurrence has been scarcely studied and with contradictory results.
  
  
  METHODS
  This was a cross-sectional observational study of diagnostic validity. It included all patients with Crohńs disease (CD) and ileocolic resection retrospectively who had had an ileocolonoscopy and a determination of faecal calprotectin before this colonoscopy, from 2007 to 2015.
  
  
  RESULTS
  Ninety-seven patients were included. We observed that the mean value of faecal calprotectin increased as the Rutgeerts score increased. The variable of that most statistical significance obtained in bivariate analysis was faecal calprotectin (p < 0.0001). Area under curve (AUC) of faecal calprotectin in endoscopic recurrence was 0.74 (95% CI: 0.644-0.842), and an optimal cut-off of 60 mcrgr/gr, obtained a score of 0.45 using Youden test. This indicated that calprotectin would have 88% Sensitivity and 58% Specificity in detecting any recurrence, the NPV was approximately 83,9%. None of the other variables studied had a significant correlation.
  
  
  CONCLUSIONS
  Faecal calprotectin predicts endoscopic recurrence in CD patients who have gone through surgery, however the cut-off point is still a problem so we cannot recommend calprotectin as a substitute of colonoscopy for CD monitoring and treatment adjustment.
authors.affiliation: a Department of Gastroenterology , Rio Hortega Hospital, Valladolid , Calle Dulzaina, 2 , Valladolid , Spain ;
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Herranz Bachiller
authors.affiliation: a Department of Gastroenterology , Rio Hortega Hospital, Valladolid , Calle Dulzaina, 2 , Valladolid , Spain ;
authors.forename: Jesus
authors.initials: J
authors.lastname: Barrio Andres
authors.affiliation: b Department of Gastroenterology, Universitary Clinic Hospital, Valladolid , Calle Ramón Y Cajal, S/N , Valladolid , Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Fernandez Salazar
authors.affiliation: a Department of Gastroenterology , Rio Hortega Hospital, Valladolid , Calle Dulzaina, 2 , Valladolid , Spain ;
authors.forename: Rafael
authors.initials: R
authors.lastname: Ruiz-Zorrilla
authors.affiliation: a Department of Gastroenterology , Rio Hortega Hospital, Valladolid , Calle Dulzaina, 2 , Valladolid , Spain ;
authors.forename: Lorena
authors.initials: L
authors.lastname: Sancho Del Val
authors.affiliation: a Department of Gastroenterology , Rio Hortega Hospital, Valladolid , Calle Dulzaina, 2 , Valladolid , Spain ;
authors.forename: Ramon
authors.initials: R
authors.lastname: Atienza Sanchez
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D003082:Colectomy; D003113:Colonoscopy; D003424:Crohn Disease / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D003430:Cross-Sectional Studies; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex
keywords: Endoscopic recurrence; Harvey–Bradshaw index; Rutgeerts index; faecal calprotectin