Diagnostic Possibilities of Determining the Level of Faecal Calprotectin in Clinical Practice
https://doi.org/10.22416/1382-4376-2022-32-6-53-59
Abstract
Aim: to analyze the publications devoted to the modern possibilities of determining the level of faecal calprotectin (FCP) in the diagnosis of various diseases.
Key points. In patients with already established diagnosis of inflammatory bowel diseases (IBD), dynamic monitoring of the level of FCP allows to assess the course and prognosis of the disease, as well as the effectiveness of treatment. The determining of FCP helps in the primary diagnosis of IBD (ulcerative colitis, Crohn's disease, microscopic colitis), contributing to their differentiation from functional bowel disorders, as well as in assessing the course of diverticular intestinal disease and celiac disease. The possibility of using FCP as a marker of colorectal cancer (CRC) and adenomatous polyps of the colon is also discussed.
Conclusion. Determining the level of FCP plays an important role in the diagnosis and assessment of the course of a number of gastroenterological diseases (primarily IBD). The significance of FCP as a marker of CRC requires further research.
About the Authors
A. A. Sheptulin
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Arkadiy A. Sheptulin — Dr. Sci. (Med.), Prof., Chair of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University).
119435, Moscow, Pogodinskaya str., 1, bld. 1
S. S. Kardasheva
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Svetlana S. Kardasheva — Cand. Sci. (Med.), Associate Professor, Department of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).
119991, Moscow, Pogodinskaya str., 1/1
A. A. Kurbatova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Anastasya A. Kurbatova — Cand. Sci. (Med.), Assis-tant, Department of Internal Diseases Propedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).
119991, Moscow, Pogodinskaya str., 1/1
References
1. Rokkas T., Portincasa P., Koutroubakis I.E. Fecal calprotectin in assessing inflammatory bowel disease endoscopic activity: a diagnostic accuracy meta-analysis. J Gastrointestin Liver Dis. 2018;27(3):299—306. DOI: 10.15403/jgld.2014.1121.273.pti
2. Osipenko M.F., Livzan M.A., Skalinskaya M.I., Lyalyukova E.A. The concentration of fecal calprotectin in the differential diagnosis of intestinal diseases. Ter Arkhiv. 2015;87(2):30—3 (In Russ.). DOI: 10.17116/terarkh201587230-33
3. Nikitin A.V., Vasilyeva L.V., Matiukhin A.A. Noninvasive markers of inflammatory bowel disease activity. Ross z gastroenterol gepatol koloproktol. 2016;26(6):106—11 (In Russ.). DOI: 10.22416/1382-4376-2016-6-106-111
4. Hart L., Chavannes M., Kherad O., Maedler C., Mourad N., Marcus V., et al. Faecal calprotectin predicts endoscopic and histological activity in clinically quiescent ulcerative colitis. J Crohns Colitis. 2020;14(1):46-52. DOI: 10.1093/ecco-jcc/jjz107
5. Nakov R., Nakov V., Gerova V., Tankova L. Fecal calprotectin correlates well with endoscopic activity in ulcerative colitis patients. J Gastrointestin Liver Dis. 2018;27(4):473-4. DOI: 10.15403/jgld.2014.1121.27
6. Lin W.C., Wong J.M., Tung C.C., Lin C.P., Chou J.W., Wang H.Y., et al. Taiwan Society of Inflammatory Bowel Disease Multicenter Study. Fecal calprotectin correlated with endoscopic remission for Asian inflammatory bowel disease patients. World J Gastroenterol. 2015;21(48):13566-73. DOI: 10.3748/wjg.v21.i48.13566
7. Ivashkin V.T., Shelygin Yu.A., Abdulganieva D.I., Abdulkhakov R.A., Alexeyeva O.P., Achkasov S.I., et al. Guidelines of the Russian gastroenterological association and Russian association of coloproctology on diagnostics and treatment of ulcerative colitis in adults. Russian z gastroenterol gepatol koloproktol. 2015;25(1):48-65 (In Russ.).
8. Conroy S., Hale M.F., Cross S.S., Swallow K., Sidhu R.H., Sargur R., Lobo A.J. Unrestricted faecal calprotectin testing performs poorly in the diagnosis of inflammatory bowel disease in patients in primary care. J Clin Pathol. 2018;71(4):316-22. DOI: 10.1136/jclinpath-2017-204506
9. Kopylov U., Yung D.E., Engel T., Avni T., Battat R., Ben-Horin S., et al. Fecal calprotectin for the prediction of small-bowel Crohn's disease by capsule endoscopy: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2016;28(10):1137-44. DOI: 10.1097/MEG.0000000000000692
10. Sipponen T., Haapamaki J., Savilahti E., Alfthan H., Hamalainen E., Rautiainen H., et al. Fecal calprotectin and S100A12 have low utility in prediction of small bowel Crohn's disease detected by wireless capsule endoscopy. Scand J Gastroenterol. 2012;47(7):778-84. DOI: 10.3109/00365521.2012.677953
11. Costa F., Mumolo M.G., Ceccarelli L., Bellini M.R., Romano M.R., Sterpi C., et al. Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn's disease. Gut. 2005;54(3):364-8. DOI: 10.1136/gut.2004.043406
12. Molander P., Farkkila M., Ristimaki A., Salminen K., Kemppainen H., Blomster T., et al. Does fecal calprotectin predict short-term relapse after stopping TN-Fa-blocking agents in inflammatory bowel disease patients in deep remission? J Crohns Colitis. 2015;9(1):33—40. DOI: 10.1016/j.crohns.2014.06.01
13. Bjorkesten C.G., Jussila A., Kemppainen H., Hallinen T., Soini E., Mankinen P., et al. Relationship of faecal calprotectin and long-term outcomes in Finnish patients with Crohn's disease: retrospective multi-centre chart review study. Scand J Gastroenterol. 2019;54(10):1226—32. DOI: 10.1080/00365521.2019.1667426
14. Lozoya Angulo M.E., de Las Heras Gomez I., Martinez Villanueva M., Noguera Velasco J.A., Aviles Plaza F. Faecal calprotectin, an useful marker in discriminating between inflammatory bowel disease and functional gastrointestinal disorders. Gastroenterol Hepatol. 2017;40(3): 125-31. DOI: 10.1016/j.gastrohep.2016.04.009
15. Banerjee A., Srinivas M., Eyre R., Ellis R., Waugh N., Bardhan K.D. Basumani P. Faecal calprotectin for differentiating between irritable bowel syndrome and inflammatory bowel disease: a useful screen in daily gastroenterology practice. Frontline Gastroenterol. 2015;6(1):20-6. DOI: 10.1136/flgastro-2013-100429
16. Waugh N., Cummins E., Royle P., Kandala N.B., Shyangdan D., Arasaradnam R., et al. Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation. Health Technol Assess. 2013;17(55):xv-xix, 1-211. DOI: 10.3310/hta17550
17. An Y.-K., Prince D., Gardiner F., Neeman T., Linedale E.C., Andrews J.M., et al. Faecal calprotectin testing for identifying patients with organic gastrointestinal disease: systematic review and meta-analysis. Med J Aust. 2019;211(10):461-7. DOI: 10.5694/mja2.50384
18. Ivashkin V.T., Shelygin Yu.A., Baranskaya Ye.K., Belousova Ye.A., Beniashvili A.G., Vasilyev S.V. Diagnosis and treatment of the irritable bowel syndrome: clinical guidelines of the Russian gastroenterological association and Russian association of coloproctology. Russian z gastroenterol gepatol koloproktol. 2017;27(5):76-93 (In Russ.). DOI: 10.22416/1382-4376-2017-27-5-76-93
19. Melchior C., Aziz M., Aubry T., Gourcerol G., Quillaume G., Quillard M., et al. Does calprotectin level identify a subgroup among patients suffering from irritable bowel syndrome? Results of a prospective study. United European Gastroenterol J. 2017 Mar;5(2):261-9. DOI: 10.1177/2050640616650062
20. Safwat E., Salah M., Hussein H. Faecal calprotectin levels after rifaximin treatment in patients with irritable bowel syndrome with diarrhoea: A single-center prospective study. Arab J Gastroenterol. 2020;21(4):273-7. DOI: 10.1016/j.ajg.2020.08.003
21. Kan Y.M., Chu S.Y., Loo C.K. Diagnostic accuracy of fecal calprotectin in predicting significant gastrointestinal diseases. JGH Open. 2021;5(6):647-52. DOI: 10.1002/jgh3.12548
22. Freeman K., Taylor-Phillips S., Willis B.H., Ryan R., Clarke A. Test accuracy of faecal calprotectin for inflammatory bowel disease in UK primary care: a retrospective cohort study of the IMRD-UK data. BMJ Open. 2021;11(2):e044177. DOI: 10.1136/bmjop-en-2020-044177
23. 0stgard R.D., Deleuran B.W., Dam M.Y., Hansen I.T., Jurik A.G., Glerup H. Faecal calprotectin detects subclinical bowel inflammation and may predict treatment response in spondyloarthritis. Scand J Rheumatol. 2018;47(1):48-55. DOI: 10.1080/03009742.2017.1299216
24. Fauny M., D'Amico F., Bonovas S., Netter P., Danese S., Loeuille D., Peyrin-Biroulet L.J. Faecal calprotectin for the diagnosis of bowel inflammation in patients with rheumatological diseases: a systematic review. Crohns Colitis. 2020;14(5):688-693. DOI: 10.1093/ecco-jcc/jjz205. PMID: 31858121
25. Von Arnim U, Wex T, Ganzert C, Schulz C, Malfertheiner P. Fecal calprotectin:a marker for clinical differentiation of microscopic colitis and irritable bowel syndrome. Clin Exp Gastroenterol. 2016;9:97-103. DOI: 10.2147/CEG.S97701
26. Wildt S., Nordgaard-Lassen I., Bendtsen F., Rumessen J.J. Metabolic and inflammatory faecal markers in collagenous colitis. Eur J Gastroenterol Hepatol. 2007;19(7):567-74. DOI: 10.1097/MEG.0b013e328058ed76
27. Tursi A., Brandimarte G., Elisei W., Giorgetti G.M., Inchingolo C.D., Aiello F. Faecal calprotectin in colonic diverticular disease: a case-control study. Int J Colorectal Dis. 2009;24(1):49-55. DOI: 10.1007/s00384-008-0595-9
28. Ivashkin V.T., Shelygin Yu.A., Achkasov S.I., Vasilyev S.V., Grigoryev Ye.G., Dudka V.V., et al. Diagnostics and treatment of diverticular disease of the colon: guidelines of the Russian gastroenterological Association and Russian Association of Coloproctology. Ross z gastroenterol gepatol koloproctol. 2016;26(1):65-80 (In Russ.). DOI: 10.22416/1382-4376-2016-26-1-65-80
29. Montalto M., Santoro L., Curigliano V., D'Onofrio F., Cammarota G., Panunzi S., et al. Faecal calprotectin concen-trations in untreated coeliac patients. Scand J Gastroenterol. 2007;42(8):957-61. DOI: 10.1080/00365520601173632
30. Ertekin V., Selimoglu M.A., Turgut A., Bakan N. Fecal calprotectin concentration in celiac disease. J Clin Gastroenterol. 2010;44(8):544-6. DOI: 10.1097/MCG.0b013e3181cadbc0
31. Balamtekin N., Baysoy G., Uslu N., Orhan D., Acoren Z., Ozen H., et al. Fecal calprotectin concentration is increased in children with celiac disease:relation with histopathological findings. Turk J Gastroenterol. 2012;23(5):503-8. DOI: 10.4318/tjg.2012.0366
32. Tibble J., Sigthorsson G., Foster G. Sherwood R., Fagerhol M., Bjarnason J. Faecal calprotectin and faecal occult blood tests in the diagnosis of colorectal carcinoma and adenoma. Gut. 2001;49(3):402-8. DOI: 10.1136/gut.49.3.402
33. Ye X., Huai J., Ding J. Diagnostic accuracy of fecal calprotectin for screening patients with colorectal cancer: A meta-analysis. Turk J Gastroenterol. 2018;29(4):397-405. DOI: 10.5152/tjg.2018.17606
34. Turvill J., Aghahoseini A., Sivarajasingham N., Abbas K., Choudhry M., Polyzois K. et al. Faecal calprotectin in patients with suspected colorectal cancer: a diagnostic accuracy study. Br J Gen Pract. 2016;66(648):e499-506. DOI: 10.3399/bjgp16X685645
35. Lundgren D., Eklof V., Palmquist R., Hultdin J., Karling P. Proton pump inhibitor use is associated with elevated faecal calprotectin levels. A cross-sectional study on subjects referred for colonoscopy. Scand J Gastroenterol. 2019;54(2):152-7. DOI: 10.1080/00365521.2019.1566493
36. Hovstadius H, Lundgren D, Karling P. Elevated faecal calprotectin in patients with a normal colonoscopy: does it matter in clinical practice? A retrospective observational study. Inflamm Intest Dis. 2021 May;6 (2):101-8. DOI: 10.1159/000513473
Review
For citations:
Sheptulin A.A., Kardasheva S.S., Kurbatova A.A. Diagnostic Possibilities of Determining the Level of Faecal Calprotectin in Clinical Practice. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2022;32(6):53-59. https://doi.org/10.22416/1382-4376-2022-32-6-53-59
Views:
766
Email this article 
