Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis

Background/Aims Accurate assessment of disease activity is crucial for effective management and treatment of ulcerative colitis (UC). This study evaluated the correlation between clinical, endoscopic, and histologic measures of disease activity in UC. Methods Clinical, biochemical, endoscopic, and h...

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Main Authors: Arshdeep Singh, Arshia Bhardwaj, Riya Sharma, Bhavjeet Kaur Kahlon, Ashvin Singh Dhaliwal, Dharmatma Singh, Simranjeet Kaur, Devanshi Jain, Namita Bansal, Ramit Mahajan, Kirandeep Kaur, Aminder Singh, Vikram Narang, Harpreet Kaur, Vandana Midha, Ajit Sood
Format: Article
Language:English
Published: Korean Association for the Study of Intestinal Diseases 2025-04-01
Series:Intestinal Research
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Online Access:http://irjournal.org/upload/pdf/ir-2024-00068.pdf
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author Arshdeep Singh
Arshia Bhardwaj
Riya Sharma
Bhavjeet Kaur Kahlon
Ashvin Singh Dhaliwal
Dharmatma Singh
Simranjeet Kaur
Devanshi Jain
Namita Bansal
Ramit Mahajan
Kirandeep Kaur
Aminder Singh
Vikram Narang
Harpreet Kaur
Vandana Midha
Ajit Sood
author_facet Arshdeep Singh
Arshia Bhardwaj
Riya Sharma
Bhavjeet Kaur Kahlon
Ashvin Singh Dhaliwal
Dharmatma Singh
Simranjeet Kaur
Devanshi Jain
Namita Bansal
Ramit Mahajan
Kirandeep Kaur
Aminder Singh
Vikram Narang
Harpreet Kaur
Vandana Midha
Ajit Sood
author_sort Arshdeep Singh
collection DOAJ
description Background/Aims Accurate assessment of disease activity is crucial for effective management and treatment of ulcerative colitis (UC). This study evaluated the correlation between clinical, endoscopic, and histologic measures of disease activity in UC. Methods Clinical, biochemical, endoscopic, and histologic disease activity was studied in 347 patients with UC. Agreements among various histologic classification systems, namely the Geboes Score (GS), Continuous GS, Nancy Index (NI), and Robarts Histopathology Index (RHI), were analyzed. The predictive accuracy of fecal calprotectin (FC) for endoscopic and histologic remission was assessed. Results We demonstrate a fair to moderate correlation between clinical, endoscopic, and histologic measures of disease activity in UC. There was a robust concordance among GS, Continuous GS, NI, and RHI in distinguishing between patients in histologic remission or activity. The NI detected 75% of patients who met the remission criteria according to the RHI, whereas the RHI identified all patients in remission as defined by the NI. FC levels below 150 μg/g had >70% accuracy in predicting endoscopic remission. FC levels below 150 μg/g showed ≥80% accuracy, and FC levels below 100 μg/g demonstrated ≥ 85% accuracy in predicting histologic remission, regardless of the scoring index applied. Elevated FC levels were associated with both acute and chronic inflammatory infiltrates in biopsy samples. Conclusions FC is a reliable predictor of histologic remission, with higher accuracy at lower thresholds. The GS, Continuous GS, NI, and RHI demonstrate comparable performance. FC could help stratify patients’ need for colonoscopy for the assessment of endoscopic and histologic remission.
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spelling doaj-art-d70d87c8517b41d6afdec462edaf1e832025-08-20T03:53:47ZengKorean Association for the Study of Intestinal DiseasesIntestinal Research1598-91002288-19562025-04-0123214415610.5217/ir.2024.000681089Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitisArshdeep Singh0Arshia Bhardwaj1Riya Sharma2Bhavjeet Kaur Kahlon3Ashvin Singh Dhaliwal4Dharmatma Singh5Simranjeet Kaur6Devanshi Jain7Namita Bansal8Ramit Mahajan9Kirandeep Kaur10Aminder Singh11Vikram Narang12Harpreet Kaur13Vandana Midha14Ajit Sood15 Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India Digestive Diseases Care Foundation, Ludhiana, India Elson S. Floyd College of Medicine, Washington State University, Everett, WA, USA Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India GastroLab India Pvt. Limited, Pune, India Research and Development Centre, Dayanand Medical College and Hospital, Ludhiana, India Research and Development Centre, Dayanand Medical College and Hospital, Ludhiana, India Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India Department of Pharmacology, Dayanand Medical College and Hospital, Ludhiana, India Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, India Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, IndiaBackground/Aims Accurate assessment of disease activity is crucial for effective management and treatment of ulcerative colitis (UC). This study evaluated the correlation between clinical, endoscopic, and histologic measures of disease activity in UC. Methods Clinical, biochemical, endoscopic, and histologic disease activity was studied in 347 patients with UC. Agreements among various histologic classification systems, namely the Geboes Score (GS), Continuous GS, Nancy Index (NI), and Robarts Histopathology Index (RHI), were analyzed. The predictive accuracy of fecal calprotectin (FC) for endoscopic and histologic remission was assessed. Results We demonstrate a fair to moderate correlation between clinical, endoscopic, and histologic measures of disease activity in UC. There was a robust concordance among GS, Continuous GS, NI, and RHI in distinguishing between patients in histologic remission or activity. The NI detected 75% of patients who met the remission criteria according to the RHI, whereas the RHI identified all patients in remission as defined by the NI. FC levels below 150 μg/g had >70% accuracy in predicting endoscopic remission. FC levels below 150 μg/g showed ≥80% accuracy, and FC levels below 100 μg/g demonstrated ≥ 85% accuracy in predicting histologic remission, regardless of the scoring index applied. Elevated FC levels were associated with both acute and chronic inflammatory infiltrates in biopsy samples. Conclusions FC is a reliable predictor of histologic remission, with higher accuracy at lower thresholds. The GS, Continuous GS, NI, and RHI demonstrate comparable performance. FC could help stratify patients’ need for colonoscopy for the assessment of endoscopic and histologic remission.http://irjournal.org/upload/pdf/ir-2024-00068.pdfcolitis, ulcerativebiopsyendoscopyhistology
spellingShingle Arshdeep Singh
Arshia Bhardwaj
Riya Sharma
Bhavjeet Kaur Kahlon
Ashvin Singh Dhaliwal
Dharmatma Singh
Simranjeet Kaur
Devanshi Jain
Namita Bansal
Ramit Mahajan
Kirandeep Kaur
Aminder Singh
Vikram Narang
Harpreet Kaur
Vandana Midha
Ajit Sood
Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis
Intestinal Research
colitis, ulcerative
biopsy
endoscopy
histology
title Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis
title_full Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis
title_fullStr Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis
title_full_unstemmed Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis
title_short Predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis
title_sort predictive accuracy of fecal calprotectin for histologic remission in ulcerative colitis
topic colitis, ulcerative
biopsy
endoscopy
histology
url http://irjournal.org/upload/pdf/ir-2024-00068.pdf
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