Published online Oct 14, 2018. doi: 10.3748/wjg.v24.i38.4384
Peer-review started: July 10, 2018
First decision: August 27, 2018
Revised: September 10, 2018
Accepted: October 5, 2018
Article in press: October 5, 2018
Published online: October 14, 2018
Fecal calprotectin (FC) is a useful biomarker to assess disease activity in ulcerative colitis (UC). However, appropriate cut-off values of FC for the endoscopic and histologic remission has not yet been determined in Japanese patients with UC.
Calculating the FC cut-off value of the remissions will help to evaluate disease activity instead of invasive examination such as endoscopy.
To determine cut-off values of FC for endoscopic and histologic remission in Japanese patients with UC.
We performed a retrospective study of Japanese patients with UC for measurement of FC that was measured by fluorescence enzyme immunoassay (FEI). We analyzed the relationship between FC and laboratory data, clinical activity, endoscopic score (Mayo endoscopic subscore: MES, Rachmilwitz endoscopic index: REI, ulcerative colitis endoscopic index of severity: UCEIS and histologic score (Matts grade, Riley’s histologic score).
In 131 patients, there was a statistically significant correlation between PMS and FC (P < 0.001). FC levels were significantly correlated with the MES (P < 0.001), REI (P < 0.001), UCEIS (P < 0.001), Riley’s histologic score (P = 0.006), and Matts grade (P < 0.001). Receiver-operating characteristic analyses identified the best cut-off value for the prediction of endoscopic remission as 288 μg/g, with an area under the curve (AUC) of 0.777 or 0.823, while that for histologic remission was 123 or 125 μg/g or 125 μg/g, with an AUC of 0.881 or 0.918.
FC measured by FEI is considered a predictive biomarker for endoscopic and histologic remission in Japanese patients with UC.
Our study showed that FC was useful biomarker for prediction of endoscopic and histologic activity. This research was a retrospective study, which is the maximum limitation. Further prospective studies are needed to confirm the reproducibility of the results of this research.