Predictive value of faecal calprotectin in ulcerative colitis – single centre experience

Abstract

Objectives Faecal calprotectin is an important biomarker used in the evaluation of inflammatory bowel disease. The aim of this study was to establish the value of faecal calprotectin concentration as a predictor of remission in ulcerative colitis and its correlation with laboratory, endoscopic and clinical findings. Methods The single centre study included 126 adult patients with established diagnosis of ulcerative colitis consecutively visiting our Day clinic from March 2017 to March 2019. We measured serum biomarkers- CRP, haemoglobin, leukocytes and platelets. Faecal calprotectin was determined from stool, and endoscopy was performed with calculation of MAYO endoscopic subscore system (MES 0–1: remission, and MES 2–3: active disease). Clinical assessment was done by using Mayo score for ulcerative colitis (clinical Mayo score <2:remission, >5: active disease).The statistical analysis was performed using an univariate and multivariate model of disease remission prediction using logistic regression. Results According to univariate analysis the increase of faecal calprotectin concentration by 10 ug/g is associated with an 8% decrease in probability of disease remission (OR 0.9921, p < .05). In the multivariate analysis, faecal calprotectin remained a significant predictor of disease remission (OR 0.9948, 95% CI 0.9914–0.9982, p = .0028), however, with a significant contribution of C-reactive protein (OR 0.8340, 95% CI 0.7085–0.9818, p = .0292). According to our model the cut off value for faecal calprotectin was 154 ug/g. Conclusion Our results have shown that faecal calprotectin is an independent predictor of remission in UC patients. The results of our study represent real-life data from a single university centre dealing with FC as a prognostic marker in patients with UC. KEY MESSAGES Faecal calprotectin is an independent predictor of remission in UC patients. Recent studies have suggested that calprotectin correlates well with endoscopic activity of inflammation but correlation of faecal calprotectin in a phase of remission hasn’t been evaluated yet. We have found that other inflammatory biomarkers do not correlate well with either endoscopic or clinical activity in ulcerative colitis.

Trefoil factor 3, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as predictor markers in ulcerative colitis activity

“…D'Amico et al (2020) indicated that there was a high statistically significant elevate in FC findings among active UC patients and patients in remission state [22] . Grgić et al (2022) reported significantly higher median FC in active UC patients (382,5 ug/g) versus inactive patients (44 ug/g) [23] . In this research, TFF3 was statistically significantly elevated in group I compared to group II and in group IA compared to group IB.…”

Evaluation of the diagnostic performance of estimated fecal calprotectin and serum intelectin-1 and C-reactive protein solo or in combination for differentiation between patients with query ulcerative colitis, Crohn’s disease and irritable bowel syndrome

“…Because of the significantly lower levels in UC & Crohn's disease patient samples than in controls & IBS patient samples, reduced serum levels of intelectin-1 may be used to distinguish among studied cases with UC & healthy controls, as well as among IBS studied cases & healthy controls due to the nonsignificant variation in IBS patient & control samples (4). (7).…”