Association Between Fecal Calprotectin Levels and Small-bowel Inflammation Score in Capsule Endoscopy: A Multicenter Retrospective Study

作者：Koulaouzidis Anastasios; Sipponen Taina; Nemeth Artur; Makins Richard; Kopylov Uri; Nadler Moshe; Giannakou Andry; Yung Diana E^*; Johansson Gabriele Wurm; Bartzis Leonidas; Thorlacius Henrik; Seidman Ernest G; Eliakim Rami; Plevris John N; Toth Ervin

来源：Digestive Diseases and Sciences, 2016, 61(7): 2033-2040.

DOI：10.1007/s10620-016-4104-7

• Capsule endoscopy
• Fecal calprotectin
• Lewis score
• Small-bowel inflammation
• Monocyte count
• C-reactive protein
• Multicenter study

Accurate inflammation reporting in capsule endoscopy (CE) is important for diagnosis and monitoring of treatment of inflammatory bowel disease (IBD). Fecal calprotectin (FC) is a highly specific biomarker of gut inflammation. Lewis score (LS) was developed to standardize quantification of inflammation in small-bowel (SB) CE images.
Multicenter retrospective study aiming to investigate correlation between LS and FC in a large group of patients undergoing CE for suspected or known small-bowel IBD, and to develop a model for prediction of CE results (LS) based on FC levels.
Five academic centers and a district general hospital offering CE in UK, Finland, Sweden, Canada, and Israel. In total, 333 patients were recruited. They had small-bowel CE and FC done within 3 months.
Overall, correlation between FC and LS was weak (r (s): 0.232, P < 0.001). When two clinically significant FC thresholds (100 and 250 mu g/g) were examined, the r (s) between FC and LS was 0.247 (weak) and 0.337 (moderate), respectively (P = 0.307). For clinically significant (LS a parts per thousand yen 135) or negative (LS < 135) for SB inflammation, ROC curves gave an optimum cutoff point of FC 76 mu g/g with sensitivity 0.59 and specificity 0.41. Limitations: Retrospective design.
LS appears to show low correlation with FC as well as other serology markers of inflammation. FC does not appear to be a reliable biomarker for significant small-bowel inflammation. Nevertheless, FC level a parts per thousand yen 76 mu g/g may be associated with appreciable visual inflammation on small-bowel CE in patients with negative prior diagnostic workup.

• 出版日期2016-7