Extent of disease affects the usefulness of fecal biomarkers in ulcerative colitis

BMC Gastroenterology

Masayoshi Yoneyama¹  Oki Kikuchi²  Tadakazu Hisamatsu²  Ryo Ozaki²  Daisuke Saito²  Jun Miyoshi²  Akihito Sakuraba²  Noritaka Hibi²  Minoru Matsuura²  Miki Miura²  Tatsuya Mitsui²  Sotaro Tokunaga²  Shintaro Minowa²  Mari Hayashida²  Nobuki Nemoto²  Hiroaki Ohnishi³ 

[1] Department of Clinical Laboratory, Kyorin University Hospital, Tokyo, Japan;Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, 181-8611, Tokyo, Japan;Department of Laboratory Medicine, Kyorin University School of Medicine, Tokyo, Japan;

关键词: Disease extension;    Fecal calprotectin;    Fecal immunochemical test;    Ulcerative colitis;    Mayo endoscopic subscore;   

DOI  :  10.1186/s12876-021-01788-4

来源: Springer

【 摘 要 】

BackgroundFecal biomarkers are considered to be useful surrogate markers for endoscopic activity. Given the mechanisms of fecal biomarkers, we hypothesized that the extent of ulcerative colitis (UC; pancolitis, left-sided colitis, and proctitis) could affect the usefulness of fecal biomarkers for assessing endoscopic and clinical disease activity; however, few studies have evaluated the utility of fecal biomarkers in the disease extent of UC.MethodsFecal calprotectin, a fecal immunochemical test for hemoglobin, and fecal lactoferrin were used as fecal biomarkers. UC patients, who underwent colonoscopy within 30 days of the fecal biomarker test, participated in this observational study. Clinical and endoscopic disease activity was assessed using the Lichtiger Index and Mayo endoscopic subscore (MES), respectively.ResultsA total of 162 colonoscopies were performed on 133 UC patients. A correlation analysis between each biomarker and the MES for each disease-extent subgroup showed a decreased correlation in the proctitis compared with the other groups. With the exception of proctitis, it was possible to distinguish between MES 0 and MES ≥ 1 with high area-under-the-curve values for fecal calprotectin and fecal lactoferrin. The fecal immunochemical test for hemoglobin was superior at discriminating MES 0 for proctitis.ConclusionsFor the practical application of fecal biomarkers for UC patients, it is necessary to consider disease extent before use. In particular, patients with proctitis exhibit a low correlation between stool biomarkers and endoscopic findings. The usefulness of these biomarkers for endoscopic remission is reduced, except for the fecal immunochemical test for hemoglobin.

【 授权许可】

CC BY