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- Title
Low Levels of Fecal Calprotectin 3 Months After Surgery Predict Subsequent Endoscopic Postoperative Remission in Crohn's Disease.
- Authors
Veyre, Florian; Boschetti, Gilles; Meunier, Camille; Cuerq, Charlotte; Gay, Claire; Charlois, Anne-Laure; Duclaux-Loras, Remi; Danion, Pauline; Cotte, Eddy; Kepenekian, Vahan; Mialon, Anne; Faure, Mathias; Roblin, Xavier; Flourie, Bernard; Nancey, Stéphane
- Abstract
Background/Aims: In Crohn's disease (CD) few data are available on the usefulness of monitoring fecal calprotectin (FC) in the early postoperative setting. We assessed prospectively the accuracy of FC measured 3 months after surgery to predict the risk of endoscopic postoperative recurrence (POR) within 1 year after resection. Methods: In 55 consecutive CD patients who had undergone ileocolonic resection samples were collected 3 months after surgery for measuring serum CRP and FC. Endoscopic POR was assessed by ileocolonoscopy within 6–12 months (median 7 months). Receiver operating characteristic (ROC) curves were generated to assess accuracy of the markers, to determine the best threshold and to calculate sensitivity, specificity, positive and negative predictive values. Results: In contrast with median CRP levels, median FC concentrations measured 3 months after surgery were significantly higher in patients who later experienced endoscopic POR (Rutgeerts ≥ i2) compared with those who stayed in endoscopic remission within the following 6–12 months (205 μg/g IQR [106–721] vs. 103 μg/g IQR [60–219], p = 0.008). Area under the ROC curve for FC was 0.71. The best cutoff value of FC to identify patients in subsequent endoscopic remission 3 months after surgery was 65 μg/g (96% sensitivity, 31% specificity, 50% positive and 91% negative predictive values). In multivariate analysis, FC < 65 µg/g at 3 months was the only factor associated with subsequent endoscopic remission. Conclusion: FC measured 3 months after surgery below 65 μg/g is an accurate marker to identify CD patients who will later stay in endoscopic remission within 1 year after resection.
- Subjects
CROHN'S disease; CALPROTECTIN; ENDOSCOPIC surgery; RECEIVER operating characteristic curves; REFERENCE values; C-reactive protein
- Publication
Digestive Diseases & Sciences, 2021, Vol 66, Issue 12, p4429
- ISSN
0163-2116
- Publication type
Article
- DOI
10.1007/s10620-020-06751-z