P180 The new faecal marker matrix metalloprotease-9 is more sensitive for postoperative endoscopic recurrence than fecal calprotectin in Crohn's disease
R. Róka1, K. Farkas1, M. Rutka1, I. Földesi1, Z. Szepes1, J. Tajti2, Z. Simonka2, S. Ábrahám2, G. Lázár2, A. Bálint1, M. Szucs3, F. Nagy1, R. Bor*1, Á. Milassin1, T. Molnár1
1University of Szeged, 1st Department of Medicine, Szeged, Hungary, 2University of Szeged, Department of Surgery, Szeged, Hungary, 3University of Szeged, Department of Medical Physics and Informatics, Szeged, Hungary
Faecal calprotectin (FC) has been published to predict endoscopic postoperative recurrence in Crohn's disease (CD) patients. The role of the new faecal activity marker, matrix metalloprotease (MMP)-9 has not been examined in postoperative CD. The aim of this study was to assess the diagnostic accuracy of faecal MMP-9 and to compare it with FC in patients with CD who underwent bowel resection or colectomy.
FC and faecal MMP-9 were determined simultaneously by enzyme-linked immunoassay test in patients with postoperative CD undergoing colonoscopy. Clinical disease activity was assessed according to the Crohn's Disease Activity Index (CDAI). Postoperative recurrence was determined according to the Rutgeerts' score.
Ileocolonoscopy was performed in 24 patients with postoperative CD (12 patients with bowel resection and 12 patients with colectomy or hemicolectomy). FC levels did not correlate with the Rutgeerts' score (R=0.25; p=0.3012). Faecal MMP-9 showed a stronger, but statistically not significant correlation with the Rutgeerts' score (R=0.356, p=0.095). However, the prediction of postoperative recurrence presented an AUC of 0.87 with a cut-off value of 0.15 ng/mL (p=0.049), the sensitivity of 64% and the specificity of 83% in case of MMP-9. In case of FC, due to the low value of AUC, cut-off value, sensitivity and specificity could not be determined. Median faecal MMP-9 levels discriminated Rutgeerts' score 0-1 from 2-4 were 0.19 vs. 0.75 ng/mL respectively.
This is the first study assessing the diagnostic accuracy of MMP-9 in postoperative CD. Our Results showed that faecal MMP-9 has higher sensitivity and specificity in the detection of postoperative recurrence in CD compared to FC.