Fecal calprotectin and S100A12 have low utility in prediction of small bowel Crohn's disease detected by wireless capsule endoscopy

• Published in: Scandinavian journal of gastroenterology 2012-07, Vol.47 (7), p.778-784
• Main Authors: Sipponen, Taina, Haapamäki, Johanna, Savilahti, Erkki, Alfthan, Henrik, Hämäläinen, Esa, Rautiainen, Henna, Koskenpato, Jari, Nuutinen, Hannu, Färkkilä, Martti
• Format: Article
• Language: English
• Subjects: Adult; Aged; Area Under Curve; Biological and medical sciences; biomarkers; Biomarkers - analysis; Capsule Endoscopy; Crohn Disease - diagnosis; Crohn Disease - pathology; Crohn's disease activity; Digestive system. Abdomen; Endoscopy; fecal markers; Feces - chemistry; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; IBD; Intestine, Small - pathology; Investigative techniques, diagnostic techniques (general aspects); Leukocyte L1 Antigen Complex - analysis; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Predictive Value of Tests; ROC Curve; S100 Proteins - analysis; S100A12 Protein; small intestine; Statistics, Nonparametric; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Young Adult
• ISSN: 0036-5521; 1502-7708
• DOI: 10.3109/00365521.2012.677953

Abstract Objective. Data on fecal calprotectin and S100A12 in predicting wireless capsule endoscopy (WCE) findings in suspicion of Crohn's disease (CD) are scarce. Our aim was to study the role of calprotectin and S100A12 in predicting inflammatory lesions of small bowel in patients undergoing WCE. Material and methods. 84 patients undergoing WCE (77 for suspicion of CD and 7 CD patients for evaluation of disease extent) were prospectively recruited. WCE findings were scored. Patients provided a stool sample for measurements of biomarkers. Patients underwent an esophagogastroduodenoscopy and ileocolonoscopy before WCE. Results. WCE was abnormal in 35 (42%) of 84 patients: 14 patients with CD, 8 with NSAID enteropathies, 8 with angioectasias, 4 with polyps or tumors, and 1 with ischemic stricture. Median calprotectin concentration in the study population was 22 μg/g (range 2-342) and S100A12 concentration 0.048 μg/g (range 0.003-1.215). Fecal calprotectin was significantly higher in CD patients (median 91, range 2-312) compared with those with normal WCE or other abnormalities (p = 0.008), whereas fecal S100A12 (0.087 μg/g, range 0.008-0.896) did not differ between the groups (p = 0.166). In detecting inflammatory small bowel lesions, sensitivity, specificity, positive predictive value, and negative predictive value for fecal calprotectin (cutoff 50 μg/g) were 59%, 71%, 42%, and 83%, and for S100A12 (cutoff 0.06 μg/g) these were 59%, 66%, 38%, and 82%. Conclusions. In predicting small bowel inflammatory changes, fecal biomarkers calprotectin and S100A12 have moderate specificity, but low sensitivity. Neither fecal calprotectin nor S100A12 can be used for screening or excluding small bowel CD.