Optimal Range of Fecal Calprotectin for Predicting Mucosal Healing in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

被引:16
作者
Xiang, Bing-Jie [1 ]
Jiang, Min [1 ]
Sun, Ming-Jun [1 ]
Dai, Cong [1 ]
机构
[1] China Med Univ, Affiliated Hosp 1, Dept Gastroenterol, 92 Beier Rd, Shenyang 110001, Peoples R China
关键词
Diagnostic accuracy; Meta-analysis; Fecal immunochemical test; Inflammatory bowel disease; Ulcerative colitis; Fecal calprotectin; ULCERATIVE-COLITIS; IMMUNOCHEMICAL TEST; CROHNS-DISEASE; RAPID TEST; MARKERS; LACTOFERRIN; BIOMARKER; CHILDREN; LEVEL; TOOL;
D O I
10.1159/000514196
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objective: Fecal calprotectin (FC) is a promising marker for assessment of inflammatory bowel disease (IBD) activity. However, the utility of FC for predicting mucosal healing (MH) of IBD patients has yet to be clearly demonstrated. The objective of our study was to perform a meta-analysis evaluating the diagnostic accuracy of FC in predicting MH of IBD patients. Methods: We systematically searched the databases for studies from inception to April 2020 that evaluated MH in IBD. The methodological quality of each study was assessed according to the Quality Assessment of Diagnostic Accuracy Studies checklist. The extracted data were pooled using a summary receiver operating characteristic curve model. Random-effects model was used to summarize the diagnostic odds ratio, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Results: Sixteen studies comprising 1,682 ulcerative colitis (UC) patients and 4 studies comprising 221 Crohn's disease (CD) patients were included. The best performance of FC for predicting MH in UC was at cut-off range of 60-75 mu g/g with area under the curve (AUC) of 0.88 and pooled sensitivity and specificity of 0.87 and 0.79, respectively. The pooled sensitivity and specificity values of cutoff range 180-250 mu g/g for predicting MH in CD were 0.67 and 0.76, respectively. The AUC of 0.79 also revealed improved discrimination for identifying MH in CD with FC concentration. Conclusion: Our meta-analysis has found that FC is a simple, reliable noninvasive marker for predicting MH in IBD patients. FC cutoff range 60-75 mu g/g appears to have the best overall accuracy in UC patients.
引用
收藏
页码:338 / 348
页数:11
相关论文
共 46 条
[1]   Level of Fecal Calprotectin Correlates With Severity of Small Bowel Crohn's Disease, Measured by Balloon-assisted Enteroscopy and Computed Tomography Enterography [J].
Arai, Tsunetaka ;
Takeuchi, Ken P. ;
Miyamura, Miyuki ;
Ishikawa, Rumiko ;
Yamada, Akihiro ;
Katsumata, Masao ;
Igarashi, Yoshinori ;
Suzuki, Yasuo .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2017, 15 (01) :56-62
[2]   Lactoferrin: A multifunctional glycoprotein involved in the modulation of the inflammatory process [J].
Baveye, S ;
Elass, E ;
Mazurier, J ;
Spik, G ;
Legrand, D .
CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 1999, 37 (03) :281-286
[3]   Fecal lactoferrin, a marker of intestinal inflammation in children with inflammatory bowel disease [J].
Borkowska, Anna ;
Liberek, Anna ;
Luczak, Grazyna ;
Jankowska, Agnieszka ;
Plata-Nazar, Katarzyna ;
Korzon, Maria ;
Kaminska, Barbara .
ACTA BIOCHIMICA POLONICA, 2015, 62 (03) :541-545
[4]   The sensitivity of fecal calprotectin in predicting deep remission in ulcerative colitis [J].
Carlsen, Katrine ;
Riis, Lene Buhl ;
Elsberg, Henriette ;
Maagaard, Louise ;
Thorkilgaard, Tine ;
Sorbye, Sveinung Wergeland ;
Jakobsen, Christian ;
Wewer, Vibeke ;
Florholmen, Jon ;
Goll, Rasmus ;
Munkholm, Pia .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 2018, 53 (07) :825-830
[5]   Role of faecal calprotectin as non-invasive marker of intestinal inflammation [J].
Costa, F ;
Mumolo, MG ;
Bellini, M ;
Romano, MR ;
Ceccarelli, L ;
Arpe, P ;
Sterpi, C ;
Marchi, S ;
Maltinti, G .
DIGESTIVE AND LIVER DISEASE, 2003, 35 (09) :642-647
[6]   Fecal calprotectin is a surrogate marker for endoscopic lesions in inflammatory bowel disease [J].
D'Haens, Geert ;
Ferrante, Marc ;
Vermeire, Severine ;
Baert, Filip ;
Noman, Maja ;
Moortgat, Liesbeth ;
Geens, Patricia ;
Iwens, Doreen ;
Aerden, Isolde ;
Van Assche, Gert ;
Van Olmen, Gust ;
Rutgeerts, Paul .
INFLAMMATORY BOWEL DISEASES, 2012, 18 (12) :2218-2224
[7]   Fecal immunochemical test for predicting mucosal healing in ulcerative colitis patients: A systematic review and meta-analysis [J].
Dai, Cong ;
Jiang, Min ;
Sun, Ming-Jun ;
Cao, Qin .
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2018, 33 (05) :990-997
[8]   Comparative study of a new quantitative rapid test with an established ELISA method for faecal calprotectin [J].
Dolci, Alberto ;
Panteghini, Mauro .
CLINICA CHIMICA ACTA, 2012, 413 (1-2) :350-351
[9]   A new rapid home test for faecal calprotectin in ulcerative colitis [J].
Elkjaer, M. ;
Burisch, J. ;
Hansen, V. Voxen ;
Kristensen, B. Deibjerg ;
Jensen, J-K. Slott ;
Munkholm, P. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2010, 31 (02) :323-330
[10]   Head to head comparison of two commercial fecal calprotectin kits as predictor of Mayo endoscopic sub-score and mucosal TNF expression in ulcerative colitis [J].
Goll, Rasmus ;
Heitmann, Richard ;
Moe, Oystein Kittel ;
Carlsen, Katrine ;
Florholmen, Jon .
PLOS ONE, 2019, 14 (12)