Published online Dec 28, 2015. doi: 10.3748/wjg.v21.i48.13566
Peer-review started: July 4, 2015
First decision: July 19, 2015
Revised: August 6, 2015
Accepted: September 14, 2015
Article in press: September 15, 2015
Published online: December 28, 2015
AIM: To evaluate the correlation between fecal calprotectin (fC), C-reactive protein (CRP), and endoscopic disease score in Asian inflammatory bowel disease (IBD) patients.
METHODS: Stool samples were collected and assessed for calprotectin levels by Quantum Blue Calprotectin High Range Rapid test. Crohn’s disease endoscopic index of severity (CDEIS) and ulcerative colitis endoscopic index of severity (UCEIS) were used for endoscopic lesion scoring.
RESULTS: A total of 88 IBD patients [36 patients with Crohn’s disease (CD) and 52 with ulcerative colitis (UC)] were enrolled. For CD patients, fC correlated with CDEIS (r = 0.465, P = 0.005) and CRP (r = 0.528, P = 0.001). fC levels in UC patients correlated with UCEIS (r = 0.696, P < 0.0001) and CRP (r = 0.529, P = 0.0005). Calprotectin could predict endoscopic remission (CDEIS < 6) with 50% sensitivity and 100% specificity (AUC: 0.74) in CD patients when using 918 μg/g as the cut-off. When using 191 μg/g as the cut-off in UC patients, calprotectin could be used for predicting endoscopic remission (UCEIS < 3) with 88% sensitivity and 75% specificity (AUC: 0.87).
CONCLUSION: fC correlated with both CDEIS and UCEIS. fC could be used as a predictor of endoscopic remission for Asian IBD patients.
Core tip: Mucosal healing is the goal in treating inflammatory bowel disease patients, and endoscopic examination remains the gold standard for evaluating mucosal status. Our results provide more evidence that fecal calprotectin (fC) correlates well with mucosal disease activity by using endoscopic disease score of ulcerative colitis endoscopic index of severity (UCEIS) and Crohn's disease endoscopic index of severity (CDEIS). The correlation of fC was higher in UCEIS than in CDEIS. fC could be used as a predictor of endoscopic remission for Asian inflammatory bowel disease patients.