title: Fecal Immunochemical Test Versus Fecal Calprotectin for Prediction of Mucosal Healing in Crohn's Disease.
abstract: BACKGROUND
  Mucosal healing (MH) has been proposed as a treatment goal of inflammatory bowel disease patients. We reported recently that not only fecal calprotectin (Fcal) but also the fecal immunochemical test (FIT) can predict MH in ulcerative colitis. However, the predictive power of the fecal markers for MH in Crohn's disease (CD), particularly with small bowel lesions, has not been reported in detail. The aim of this study was to evaluate the predictability of FIT versus Fcal for MH in CD.
  
  
  METHODS
  Consecutive CD patients underwent colonoscopy or balloon-assisted enteroscopy according to the disease location. FIT and Fcal were examined using stool samples collected the day before endoscopy.
  
  
  RESULTS
  Seventy-one CD patients were analyzed, of whom 42 (59%) underwent balloon-assisted enteroscopy because of the presence of affected lesions in the small intestine. Both the Fcal and the FIT results were significantly correlated with endoscopic activity (r = 0.67 and 0.54, respectively). However, the FIT results did not correlate with the activity in patients with small bowel lesions alone, whereas Fcal did (r = 0.42 versus 0.78). Fcal predicted MH in CD with 87% sensitivity and 71% specificity, whereas the values for FIT were 96% and 48%, respectively. The specificity for MH among patients with small bowel lesions alone was low for FIT (40%) compared with Fcal (80%).
  
  
  CONCLUSIONS
  Both FIT and Fcal were correlated with the mucosal status of CD. However, the specificity of FIT was not satisfactory, particularly for small bowel lesions.
authors.affiliation: *Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan; †Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan; and ‡Department of Endoscopy, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Inokuchi
authors.forename: Jun
authors.initials: J
authors.lastname: Kato
authors.forename: Sakiko
authors.initials: S
authors.lastname: Hiraoka
authors.forename: Shiho
authors.initials: S
authors.lastname: Takashima
authors.forename: Asuka
authors.initials: A
authors.lastname: Nakarai
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takei
authors.forename: Yuusaku
authors.initials: Y
authors.lastname: Sugihara
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takahara
authors.forename: Seiji
authors.initials: S
authors.lastname: Kawano
authors.forename: Keita
authors.initials: K
authors.lastname: Harada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism*; D003113:Colonoscopy; D003424:Crohn Disease / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D005243:Feces / Q000737:chemistry*; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D039841:Leukocyte L1 Antigen Complex / Q000378:metabolism*; D008297:Male; D009092:Mucous Membrane / Q000378:metabolism* / Q000473:pathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D014945:Wound Healing / Q000502:physiology*
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D039841:Leukocyte L1 Antigen Complex