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P092. Usefulness of faecal calprotectin to detect postoperative endoscopic recurrence in Crohn's disease

M. Mañosa1,2, E. Garcia Planella3, J. Gordillo3, Y. Zabana1,2, S. Sainz3, J. Boix1, E. Cabré1,2, E. Domènech1,2

1Hospital Universitari Germans Trias i Pujol, Badalona, Spain; 2CIBERehd, Barcelona, Spain; 3Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

Endoscopic recurrence (ER) is very frequent in Crohn's disease (CD) patients undergoing intestinal resection, and its severity strongly correlates with the risk of clinical recurrence. The role of faecal calprotectin in predicting ER in asymptomatic patients has not been assessed.

Aim: To assess the relationship of faecal calprotectin concentration with the presence of ER and its severity in CD patients with intestinal resection.

Material and Methods: Faecal concentration of calprotectin was measured shortly before colonoscopic control in CD patients bearing an intestinal resection with ileo-colic anastomosis who never had developed clinical recurrence. Endoscopic findings were graded according to the Rutgeerts' index (RI). ER and severe ER were defined as RI ≥ 2 and RI ≥ 3, respectively. Calprotectin was measured using an ELISA technique in a faecal sample obtained before starting colon cleansing for colonoscopy.

Results: Sixty-four patients (mean age 39 years) were included. Twenty per cent of patients were active smokers, and 78% were on thiopurine therapy for prevention of ER. Twenty-three (36%) patients had ER (RI ≥ 2), which in 16 of them (69%) was severe (RI ≥ 3). Faecal calprotectin concentration was significantly higher in patients with than in those without ER (163.8±108 mg/kg vs. 96.3±71 mg/kg; P = 0.01). For a cut-off of 100 mg/kg of faecal calprotectin, the area under the receiving operating curve (ROC) for diagnostic accuracy of ER was 0.70 (95%CI 0.56–0.83), with a sensitivity of 62% and a specificity of 60%. For a cut-off of 80 mg/kg of faecal calprotectin, the area under the ROC for diagnostic accuracy of absence of endoscopic lesions was 0.76 (95%CI 0.65–0.88), with a sensitivity of 75% and a specificity of 60%.

Conclusion: Faecal calprotectin may be useful to predict the absence of endoscopic lesions in asymptomatic CD patients with intestinal resection, but not the predict the presence and severity of ER.