Get access

Fecal calprotectin in predicting relapse of inflammatory bowel diseases: A meta-analysis of prospective studies

Authors

  • Ren Mao MD,

    1. Department of Gastroenterology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
    Search for more papers by this author
  • Ying-lian Xiao MD,

    1. Department of Gastroenterology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
    Search for more papers by this author
  • Xiang Gao MD,

    1. Department of Gastroenterology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
    Search for more papers by this author
  • Bai-li Chen MD,

    1. Department of Gastroenterology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
    Search for more papers by this author
  • Yao He MD,

    1. Department of Gastroenterology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
    Search for more papers by this author
  • Li Yang MD,

    1. Department of Gastroenterology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
    Search for more papers by this author
  • Pin-jin Hu MD,

    1. Department of Gastroenterology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
    Search for more papers by this author
  • Min-hu Chen MD

    Corresponding author
    1. Department of Gastroenterology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
    • Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan II Road, Guangzhou 510080, People's Republic of China
    Search for more papers by this author

Abstract

Background:

Fecal calprotectin (FC) is a relatively new marker of intestinal inflammation. Recently, many studies have extended its role in predicting relapse of quiescent inflammatory bowel disease (IBD), but the reported results have been inconsistent. We aimed to perform a meta-analysis of the predictive capacity of FC in IBD relapse.

Methods:

We systematically searched the Medline, Web of Science, Cochrane Library, and EMBASE databases for prospective studies that used FC concentrations at remission in predicting relapse of Crohn's disease (CD) and ulcerative colitis (UC). Pooled sensitivity, specificity, and other diagnostic indices were evaluated.

Results:

A total of 672 IBD patients (318 UC and 354 CD) from six different studies were analyzed. The pooled sensitivity and specificity of FC to predict relapse of quiescent IBD was 78% (95% confidence interval [CI]: 72–83) and 73% (95% CI: 68–77), respectively. The area under the summary receiver-operating characteristic (sROC) curve was 0.83 and the diagnostic odds ratio was 10.31 (95% CI: 5.05–21.06). The capacity of FC to predict relapse was comparable between UC and CD. In CD patients the predictive value of FC in isolated small bowel CD was not assessed due to insufficiency of available data. Compared with all enrolled CD patients, FC appeared to be more accurate in ileocolonic and colonic CD.

Conclusions:

As a simple and noninvasive marker, FC is useful to predict relapse in quiescent IBD patients. (Inflamm Bowel Dis 2012)

Ancillary