Faecal calprotectin as a non-invasive marker of Crohn's disease in anal fistulas

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Colorectal Disease Pub Date : 2025-02-14 DOI:10.1111/codi.70026

Helene Perregaard, Freja Pust, Andreas Nordholm-Carstensen

{"title":"Faecal calprotectin as a non-invasive marker of Crohn's disease in anal fistulas","authors":"Helene Perregaard, Freja Pust, Andreas Nordholm-Carstensen","doi":"10.1111/codi.70026","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>Faecal calprotectin (FC) is a noninvasive marker that reflects intestinal inflammation with good sensitivity. A prior study indicated that FC values above 150 μg/g could distinguish between anal fistulas (AF) of cryptoglandular or Crohn's disease (CD) origin. It is hypothesized as a useful triage test to rule out CD in newly referred AF patients, thus reducing the number of ileocolonoscopies performed and optimizing treatment regimens in AF while minimizing patient discomfort as well as healthcare costs. The aim of the study was to determine the accuracy of FC in distinguishing between anal fistulas of cryptoglandular and CD origin, as well as compare characteristics in fistulas.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>Patients referred with anal fistula who had an FC measurement and either ileocolonoscopy or colonoscopy within 12 weeks were included. Demographic and clinical characteristics were registered. Area under the curve (AUC) was calculated as well as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 63 patients were included (CD <i>n</i> = 31, 49%). FC was significantly higher in CD compared to cryptoglandular fistulas, even when CD was medically treated or had no luminal activity on endoscopy. FC ≥110 μg/g was significantly associated with CD (OR 12.5; 95% CI: 3.77–41.4) <i>p</i> < 0.0001. This was found by plotting a receiver operating characteristic (ROC) curve, with AUC 80.8 (95% CI: 0.6952–0.9217). Sensitivity and specificity were 0.76 and 0.80, respectively (PPV 76%, NPV 80% and accuracy 78%).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>FC discriminates CD from cryptoglandular fistulas, even in medically treated CD with normal endoscopic findings.</p>\n </section>\n </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 2","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Colorectal Disease","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/codi.70026","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

Faecal calprotectin (FC) is a noninvasive marker that reflects intestinal inflammation with good sensitivity. A prior study indicated that FC values above 150 μg/g could distinguish between anal fistulas (AF) of cryptoglandular or Crohn's disease (CD) origin. It is hypothesized as a useful triage test to rule out CD in newly referred AF patients, thus reducing the number of ileocolonoscopies performed and optimizing treatment regimens in AF while minimizing patient discomfort as well as healthcare costs. The aim of the study was to determine the accuracy of FC in distinguishing between anal fistulas of cryptoglandular and CD origin, as well as compare characteristics in fistulas.

Method

Patients referred with anal fistula who had an FC measurement and either ileocolonoscopy or colonoscopy within 12 weeks were included. Demographic and clinical characteristics were registered. Area under the curve (AUC) was calculated as well as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.

Results

A total of 63 patients were included (CD n = 31, 49%). FC was significantly higher in CD compared to cryptoglandular fistulas, even when CD was medically treated or had no luminal activity on endoscopy. FC ≥110 μg/g was significantly associated with CD (OR 12.5; 95% CI: 3.77–41.4) p < 0.0001. This was found by plotting a receiver operating characteristic (ROC) curve, with AUC 80.8 (95% CI: 0.6952–0.9217). Sensitivity and specificity were 0.76 and 0.80, respectively (PPV 76%, NPV 80% and accuracy 78%).

Conclusion

FC discriminates CD from cryptoglandular fistulas, even in medically treated CD with normal endoscopic findings.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

求助全文

约1分钟内获得全文去求助

来源期刊

Colorectal Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

11.80%

发文量

406

审稿时长

1.5 months

期刊介绍： Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate. Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases. Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies. Note that the journal does not usually accept paediatric surgical papers.