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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| Format: | Article |
| Language: | English |
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Korean Association for the Study of Intestinal Diseases
2025-04-01
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| 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. |
| format | Article |
| id | doaj-art-d70d87c8517b41d6afdec462edaf1e83 |
| institution | Kabale University |
| issn | 1598-9100 2288-1956 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Korean Association for the Study of Intestinal Diseases |
| record_format | Article |
| series | Intestinal Research |
| 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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