Efficient diagnosis for endoscopic remission in Crohn’s diseases by the combination of three non-invasive markers
Abstract Background Serum C-reactive protein (CRP), leucine-rich alpha-2 glycoprotein (LRG), and fecal calprotectin (Fcal) are non-invasive markers used to assess Crohn’s disease (CD) severity. However, the accuracy of these markers alone is often limited, and most previous reports have evaluated th...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-05-01
|
| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-025-03880-5 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849309766742966272 |
|---|---|
| author | Kensuke Takei Toshihiro Inokuchi Sakiko Hiraoka Mikako Ishiguro Junki Toyosawa Yuki Aoyama Shoko Igawa Keiko Takeuchi Yasushi Yamasaki Hideaki Kinugasa Masahiro Takahara Seiji Kawano Toshiharu Mitsuhashi Motoyuki Otsuka |
| author_facet | Kensuke Takei Toshihiro Inokuchi Sakiko Hiraoka Mikako Ishiguro Junki Toyosawa Yuki Aoyama Shoko Igawa Keiko Takeuchi Yasushi Yamasaki Hideaki Kinugasa Masahiro Takahara Seiji Kawano Toshiharu Mitsuhashi Motoyuki Otsuka |
| author_sort | Kensuke Takei |
| collection | DOAJ |
| description | Abstract Background Serum C-reactive protein (CRP), leucine-rich alpha-2 glycoprotein (LRG), and fecal calprotectin (Fcal) are non-invasive markers used to assess Crohn’s disease (CD) severity. However, the accuracy of these markers alone is often limited, and most previous reports have evaluated the efficacy of each marker individually. We aimed to improve the diagnostic performance of endoscopic remission (ER) of CD by combining these 3 markers. Methods We tested the diagnostic ability of various combinations of these 3 markers for endoscopic severity in 230 consecutive patients with CD from September 2014 to July 2023. The modified Simple Endoscopic Score for Crohn’s disease (mSES-CD) was used to determine endoscopic severity. Results Each of the 3 markers was correlated with mSED-CD (LRG: r = 0.69, CRP: r = 0.60, and Fcal: r = 0.67). A combination of 2 of the 3 markers did not increase the diagnostic accuracy of ER. However, by combining all 3 markers, the diagnostic ability for ER was improved in comparison to the diagnostic ability of the 3 individual markers, assuming that ER was obtained if 2 or 3 markers were negative. The sensitivity, specificity, and accuracy were 89%, 83%, and 86%, respectively. Additionally, we established a 2-step method using Fcal values after evaluating the 2 serum markers. This method was most useful for reducing both the patient burden and costs. Conclusions The newly established 2-step method allowed for a higher accuracy in the non-invasive diagnosis of ER when the 3 markers were combined. |
| format | Article |
| id | doaj-art-e930c2122af441efaac368954435269e |
| institution | Kabale University |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj-art-e930c2122af441efaac368954435269e2025-08-20T03:53:58ZengBMCBMC Gastroenterology1471-230X2025-05-0125111310.1186/s12876-025-03880-5Efficient diagnosis for endoscopic remission in Crohn’s diseases by the combination of three non-invasive markersKensuke Takei0Toshihiro Inokuchi1Sakiko Hiraoka2Mikako Ishiguro3Junki Toyosawa4Yuki Aoyama5Shoko Igawa6Keiko Takeuchi7Yasushi Yamasaki8Hideaki Kinugasa9Masahiro Takahara10Seiji Kawano11Toshiharu Mitsuhashi12Motoyuki Otsuka13Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesResearch Center for Intestinal Health Science, Okayama UniversityDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesCenter for Innovative Clinical Medicine, Okayama University HospitalDepartment of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAbstract Background Serum C-reactive protein (CRP), leucine-rich alpha-2 glycoprotein (LRG), and fecal calprotectin (Fcal) are non-invasive markers used to assess Crohn’s disease (CD) severity. However, the accuracy of these markers alone is often limited, and most previous reports have evaluated the efficacy of each marker individually. We aimed to improve the diagnostic performance of endoscopic remission (ER) of CD by combining these 3 markers. Methods We tested the diagnostic ability of various combinations of these 3 markers for endoscopic severity in 230 consecutive patients with CD from September 2014 to July 2023. The modified Simple Endoscopic Score for Crohn’s disease (mSES-CD) was used to determine endoscopic severity. Results Each of the 3 markers was correlated with mSED-CD (LRG: r = 0.69, CRP: r = 0.60, and Fcal: r = 0.67). A combination of 2 of the 3 markers did not increase the diagnostic accuracy of ER. However, by combining all 3 markers, the diagnostic ability for ER was improved in comparison to the diagnostic ability of the 3 individual markers, assuming that ER was obtained if 2 or 3 markers were negative. The sensitivity, specificity, and accuracy were 89%, 83%, and 86%, respectively. Additionally, we established a 2-step method using Fcal values after evaluating the 2 serum markers. This method was most useful for reducing both the patient burden and costs. Conclusions The newly established 2-step method allowed for a higher accuracy in the non-invasive diagnosis of ER when the 3 markers were combined.https://doi.org/10.1186/s12876-025-03880-5CD, Crohn’s diseaseLRG, Leucine-rich alpha- 2 glycoproteinFcal, Fecal calprotectinCRP, C-reactive proteinER, Endoscopic remission |
| spellingShingle | Kensuke Takei Toshihiro Inokuchi Sakiko Hiraoka Mikako Ishiguro Junki Toyosawa Yuki Aoyama Shoko Igawa Keiko Takeuchi Yasushi Yamasaki Hideaki Kinugasa Masahiro Takahara Seiji Kawano Toshiharu Mitsuhashi Motoyuki Otsuka Efficient diagnosis for endoscopic remission in Crohn’s diseases by the combination of three non-invasive markers BMC Gastroenterology CD, Crohn’s disease LRG, Leucine-rich alpha- 2 glycoprotein Fcal, Fecal calprotectin CRP, C-reactive protein ER, Endoscopic remission |
| title | Efficient diagnosis for endoscopic remission in Crohn’s diseases by the combination of three non-invasive markers |
| title_full | Efficient diagnosis for endoscopic remission in Crohn’s diseases by the combination of three non-invasive markers |
| title_fullStr | Efficient diagnosis for endoscopic remission in Crohn’s diseases by the combination of three non-invasive markers |
| title_full_unstemmed | Efficient diagnosis for endoscopic remission in Crohn’s diseases by the combination of three non-invasive markers |
| title_short | Efficient diagnosis for endoscopic remission in Crohn’s diseases by the combination of three non-invasive markers |
| title_sort | efficient diagnosis for endoscopic remission in crohn s diseases by the combination of three non invasive markers |
| topic | CD, Crohn’s disease LRG, Leucine-rich alpha- 2 glycoprotein Fcal, Fecal calprotectin CRP, C-reactive protein ER, Endoscopic remission |
| url | https://doi.org/10.1186/s12876-025-03880-5 |
| work_keys_str_mv | AT kensuketakei efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT toshihiroinokuchi efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT sakikohiraoka efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT mikakoishiguro efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT junkitoyosawa efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT yukiaoyama efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT shokoigawa efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT keikotakeuchi efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT yasushiyamasaki efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT hideakikinugasa efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT masahirotakahara efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT seijikawano efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT toshiharumitsuhashi efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers AT motoyukiotsuka efficientdiagnosisforendoscopicremissionincrohnsdiseasesbythecombinationofthreenoninvasivemarkers |