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P477. Fecal calprotectin reflects mucosal healing in ulcerative colitis

D.B. Kim1, K.-M. Lee1, Y.W. Lee1, S.H. Jung2, J.M. Lee1, Y.Y. Chung1, W.C. Chung1, 1St. Vincent's Hospital, The Catholic University of Korea, Internal Medicine, Suwon, South Korea, 2St. Paul's Hospital, The Catholic University of Korea, Internal Medicine, Seoul, South Korea

Background

Mucosal healing (MH) is reported to be associated with sustained remission and reduced risk of surgery in inflammatory bowel disease (IBD). Fecal calprotectin (FC) is known to correlate with disease activity and can be used as a predictor for relapse or treatment response in IBD. We aimed to assess the usefulness of FC as a marker of MH in patients with ulcerative colitis (UC).

Methods

Endoscopic examination and stool collection were performed in twenty-nine UC patients. FC levels were analyzed by ELISA and quantitative rapid test (Quantum Blue®). Endoscopic activity was assessed according to the Mayo endoscopic score and MH was defined as endoscopic score of 0.

Results

Seven patients showed MH and the remainder showed endoscopic activity, of which Mayo endoscopic score 1 was observed in 7, score 2 in 9, and score 3 in 6 patients, respectively. FC level was significantly lower in patients with MH compared to those without MH (85.5±55.6 vs. 1503.7±2129.9 µg/g, p = 0.005). Using cutoff level of >201.3 µg/g, FC was a good predictive marker of the endoscopic activity in UC (sensitivity 81.8%, specificity 100%). The results from a quantitative rapid test corresponded well to those from ELISA.

Conclusion

FC is a good surrogate marker for MH in UC. Thus, FC has the potential to replace colonoscopy for assessment of mucosal inflammation in clinical practice.