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P287. Accuracy of fecal calprotectin in the prediction of endoscopic activity in inflammatory bowel disease patients

V. Jusué1, M. Chaparro2, J.P. Gisbert2, 1Hospital Universitario de La Princesa and IP, Gastroenterology Unit, Madrid, Spain, 2Hospital Universitario de La Princesa, IP and CIBERehd, Gastroenterology Unit, Madrid, Spain

Background

Fecal calprotectin (FC) is a noninvasive marker of inflammation used in inflammatory bowel disease (IBD).

Aim: To evaluate the accuracy of the FC to predict the presence of endoscopic activity in patients with IBD.

Methods

We prospectively included patients with IBD who underwent an endoscopy for clinical indication. The Quantum Blue ® Bühlmann kit was used to determine FC concentration. Two different kits, of low and high range, were used. Endoscopic activity was calculated by the Mayo endoscopic subscore for ulcerative colitis (UC) and the simple endoscopic score for Crohn's disease (SES-CD). CD patients with ileal disease whose ileum had not been examined during the endoscopy were excluded. Clinical activity was calculated by partial Mayo score for UC and Harvey–Bradshaw index for CD, and the values of various serum markers of inflammation (platelets, leukocytes, PCR and albumin) were recorded.

Results

34 patients have been included up to now. The concentration of FC was higher in UC patients with endoscopic lesions compared with those without endoscopic activity, with the low range kit (217±112 vs. 67±86 mg/g, p < 0.05) as well as with the high range kit (643±320 vs. 186±223 mg/g, p < 0.05). No statistically significant differences were found in CD depending on the presence of endoscopic activity. The concentration of the different serological markers (platelets, leukocytes, CRP and albumin) was not different in patients with endoscopic activity and in those without endoscopic lesions. The best cut-off points for the detection of endoscopic activity in UC patients were 81 mg/g for the low-range kit (sensitivity of 85% and specificity of 82%) and 338 mg/g for the high-range kit (sensitivity of 85% and specificity of 91%). The area under the ROC curves of FC determination for the prediction of endoscopic activity in UC were 0.72 and 0.86 with low and high range kits, respectively.

Conclusion

The determination of FC concentration has good diagnostic accuracy for the detection of endoscopic lesions in patients with UC, which is higher than the accuracy of the most commonly used serum markers of inflammation such as platelets, leukocytes, PCR or albumin. However, the diagnostic accuracy of FC is low for assessing the endoscopic activity in CD patients.