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* = Presenting author

P274 Diagnostic accuracy of fecal calprotectin and M2-pyruvate kinase in the prediction of endoscopic activity Crohn's disease

V.M. Juan María*, P.-M. Héctor, B.-R. Beatriz, O.-M. Rosario, C.-C. Manuel, R.-L. Manuel

Hospital General Juan Ramón Jiménez, UGC Aparato Digestivo, Huelva, Spain

Background

Fecal calprotectin and M2-pyruvate kinase (M2-PK) are useful biomarkers to diagnose inflammatory bowel disease. Several studies have shown a high correlation between intestinal injury and the levels of fecal biomarkers but no consensus on the optimal cutoff for establishing endoscopic activity. The aim this of study is to analyze the diagnostic accuracy of fecal calprotectin and M2-PK to predict endoscopic activity in Crohn´s disease (CD).

Methods

An observational and prospective study was designed. 71 patients with CD underwent a colonoscopy calculated simple endoscopic score for Crohn´s disease (SES-CD) and Crohn disease activity index (CDAI). Fecal calprotectina, M2-PK, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured.

Results

Forty-nine (69%) patients had endoscopic activity (SES-CD > 2). The fecal calprotectin concentration was higher among the patients with endoscopic activity than in remission: 375 µg/g (95% CI 303-448) versus 80 µg/g (95% CI 53-107); p<0.01. For the fecal M2-PK concentration also differences were observed: 17.4 U/l (95% CI 14-21) versus 4.7 U/l (95% CI 1.8-7.6); p<0.01. The SES-CD correlated closest with calprotectin (Spearman´s rank correlation coefficient r=0.739), followed by M2-PK (r=0.576), CRP (r=0.534) and ESR (r=0.516). The overall accuracy for the detection of endoscopically active disease was 92% for calprotectin (cutoff 120 µg/g), 85% for M2-PK (cutoff 4.5 U/l), 81% for CDAI, 74% for CRP and 72% for ESR.

Conclusion

Fecal calprotectin was the biomarker to predict more accurately endoscopic activity, followed by M2-PK. Serological biomarkers and CDAI have less accuracy. Fecal biomarkers, especially calprotectina, are tools with high precision to predict endoscopic activity.