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Association Between Fecal Calprotectin Levels and Small-bowel Inflammation Score in Capsule Endoscopy : A Multicenter Retrospective Study

Koulaouzidis, Anastasios LU ; Sipponen, Taina; Nemeth, Artur LU ; Makins, Richard; Kopylov, Uri; Nadler, Moshe; Giannakou, Andry; Yung, Diana E; Johansson, Gabriele Wurm LU and Bartzis, Leonidas, et al. (2016) In Digestive Diseases and Sciences 61(7). p.2033-2040
Abstract

BACKGROUND: Accurate inflammation reporting in capsule endoscopy (CE) is important for diagnosis and monitoring of treatment of inflammatory bowel disease (IBD). Fecal calprotectin (FC) is a highly specific biomarker of gut inflammation. Lewis score (LS) was developed to standardize quantification of inflammation in small-bowel (SB) CE images.

GOALS: Multicenter retrospective study aiming to investigate correlation between LS and FC in a large group of patients undergoing CE for suspected or known small-bowel IBD, and to develop a model for prediction of CE results (LS) based on FC levels.

STUDY: Five academic centers and a district general hospital offering CE in UK, Finland, Sweden, Canada, and Israel. In total, 333... (More)

BACKGROUND: Accurate inflammation reporting in capsule endoscopy (CE) is important for diagnosis and monitoring of treatment of inflammatory bowel disease (IBD). Fecal calprotectin (FC) is a highly specific biomarker of gut inflammation. Lewis score (LS) was developed to standardize quantification of inflammation in small-bowel (SB) CE images.

GOALS: Multicenter retrospective study aiming to investigate correlation between LS and FC in a large group of patients undergoing CE for suspected or known small-bowel IBD, and to develop a model for prediction of CE results (LS) based on FC levels.

STUDY: Five academic centers and a district general hospital offering CE in UK, Finland, Sweden, Canada, and Israel. In total, 333 patients were recruited. They had small-bowel CE and FC done within 3 months.

RESULTS: Overall, correlation between FC and LS was weak (r s: 0.232, P < 0.001). When two clinically significant FC thresholds (100 and 250 μg/g) were examined, the r s between FC and LS was 0.247 (weak) and 0.337 (moderate), respectively (P = 0.307). For clinically significant (LS ≥ 135) or negative (LS < 135) for SB inflammation, ROC curves gave an optimum cutoff point of FC 76 μg/g with sensitivity 0.59 and specificity 0.41.

LIMITATIONS: Retrospective design.

CONCLUSIONS: LS appears to show low correlation with FC as well as other serology markers of inflammation. FC does not appear to be a reliable biomarker for significant small-bowel inflammation. Nevertheless, FC level ≥ 76 μg/g may be associated with appreciable visual inflammation on small-bowel CE in patients with negative prior diagnostic workup.

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publication status
published
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Digestive Diseases and Sciences
volume
61
issue
7
pages
2033 - 2040
publisher
Springer
external identifiers
  • scopus:84961773584
  • wos:000379013300033
ISSN
1573-2568
DOI
10.1007/s10620-016-4104-7
language
English
LU publication?
yes
id
89e7e833-58d5-46b2-812c-8eae45990842
date added to LUP
2016-04-12 11:31:27
date last changed
2017-03-26 04:41:22
@article{89e7e833-58d5-46b2-812c-8eae45990842,
  abstract     = {<p>BACKGROUND: Accurate inflammation reporting in capsule endoscopy (CE) is important for diagnosis and monitoring of treatment of inflammatory bowel disease (IBD). Fecal calprotectin (FC) is a highly specific biomarker of gut inflammation. Lewis score (LS) was developed to standardize quantification of inflammation in small-bowel (SB) CE images.</p><p>GOALS: Multicenter retrospective study aiming to investigate correlation between LS and FC in a large group of patients undergoing CE for suspected or known small-bowel IBD, and to develop a model for prediction of CE results (LS) based on FC levels.</p><p>STUDY: Five academic centers and a district general hospital offering CE in UK, Finland, Sweden, Canada, and Israel. In total, 333 patients were recruited. They had small-bowel CE and FC done within 3 months.</p><p>RESULTS: Overall, correlation between FC and LS was weak (r s: 0.232, P &lt; 0.001). When two clinically significant FC thresholds (100 and 250 μg/g) were examined, the r s between FC and LS was 0.247 (weak) and 0.337 (moderate), respectively (P = 0.307). For clinically significant (LS ≥ 135) or negative (LS &lt; 135) for SB inflammation, ROC curves gave an optimum cutoff point of FC 76 μg/g with sensitivity 0.59 and specificity 0.41.</p><p>LIMITATIONS: Retrospective design.</p><p>CONCLUSIONS: LS appears to show low correlation with FC as well as other serology markers of inflammation. FC does not appear to be a reliable biomarker for significant small-bowel inflammation. Nevertheless, FC level ≥ 76 μg/g may be associated with appreciable visual inflammation on small-bowel CE in patients with negative prior diagnostic workup.</p>},
  author       = {Koulaouzidis, Anastasios and Sipponen, Taina and Nemeth, Artur and Makins, Richard and Kopylov, Uri and Nadler, Moshe and Giannakou, Andry and Yung, Diana E and Johansson, Gabriele Wurm and Bartzis, Leonidas and Thorlacius, Henrik and Seidman, Ernest G and Eliakim, Rami and Plevris, John N and Toth, Ervin},
  issn         = {1573-2568},
  language     = {eng},
  number       = {7},
  pages        = {2033--2040},
  publisher    = {Springer},
  series       = {Digestive Diseases and Sciences},
  title        = {Association Between Fecal Calprotectin Levels and Small-bowel Inflammation Score in Capsule Endoscopy : A Multicenter Retrospective Study},
  url          = {http://dx.doi.org/10.1007/s10620-016-4104-7},
  volume       = {61},
  year         = {2016},
}