Table 2.
Summary of studies investigating fecal biomarkers for the prediction of post-operative recurrence in patients with Crohn's disease.
| References | Location | Age median or mean* (range) | N | Time interval | Optimal cut-off | Median/mean* | P-value |
Sensitivity/ specificity % |
PPV/NPV % | Method | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| With POR | Without POR | |||||||||||
| Calprotectin | ||||||||||||
| Cerrillo et al. (85) | Spain | 40.7* (18–74) | 61 | 24 mons | 160 μg/g | - | - | - | 85/70 | 26/98 | ELISA (Calprest) | |
| Baillet et al. (86) | France | 34.9* | 30 | 1 yr | 100 μg/g | 354.8 μg/g* | 114 μg/g* | 0.0075 | 67/93 | 89/77 | Lateral Flow Assay (Buhlmann) | |
| Verdejo et al. (87) | Spain | 46.2 | 86 | <1 mon | 62 μg/g | 172.5 μg/g | 75 μg/g | 0.003 | 85.7/45.9 | 67.7/70.8 | Lateral flow assay (Buhlmann) | |
| Garcia-Planella et al. (88) | Spain | 40 | 119 | ~24 mons | 100 μg/g and 5 mg/L of CRP | 205 μg/g* | 94 μg/g* | <0.0001 | 82/53 | 54/81 | ELISA (Calprest) | |
| Wright et al. (89) | Australia and New Zealand | 36 | 135 | 18 mons | 135 μg/g | 275 μg/g | 72 μg/g | <0.001 | 87/66 | 56/91 | ELISA (Buhlmann) | |
| Lopes et al. (90) | Portugal | 45* | 99 | 25 mons# | 100 μg/g | 196.5 μg/g | 42.1 μg/g | <0.001 | 74/75 | 61/91 | Fluorescence enzyme immunoassay (Thermo Fisher Scientifi) | |
| Hukkinen et al. (91) | Finland | 13.6 (≤18) | 22 | 5.7 yrs# | 139 μg/g | - | - | - | 73/64 | 68/70 | ELISA (PhiCal) | |
| Increase of 79 μg/g | - | - | - | 73/71 | 73/71 | |||||||
| Herranz Bachiller et al. (92) | Spain | 48.6* | 97 | - | 60 μg/g | 192.45 μg/g | 94.39 μg/g | 0.0001 | 88/58 | 51.73/83.9 | ELISA (Calprest) | |
| Yamamoto et al. (93) | Japan | 32 (21–48) | 30 | 24 mons | 140 μg/g | 199 μg/g | 82.5 μg/g | 0.002 | 75/91 | 75/91 | Colloidal gold agglutination assay (Alfresa Pharma Corp.) | |
| Boschetti et al. (94) | France | 39.3* (18–70) | 86 | 18 mons | 100 μg/g | 473 μg/g* | 115 μg/g* | <0.0001 | 95/54 | 69/93 | ELISA (Buhlmann) | |
| Lasson et al. (95) | Sweden | 36 (17–63) | 30 | 1 yr | 100 μg/g | 227 μg/g | 189 μg/g | 0.25 | 85/35 | 50/75 | ELISA (Buhlmann) | |
| 200 μg/g | 54/53 | 47/60 | ||||||||||
| 250 μg/g | 46/53 | 43/56 | ||||||||||
| ∧Yamamoto et al. (96) | Japan | 32* | 20 | 12 mons | 140 μg/g | 229.5 μg/g* | 102.3 μg/g* | 0.005 | 70/70 | 70/70 | ELISA (Cell sciences) | |
| Lobatón et al. (97) | Spain | 40 | 115 | - | 272 μg/g | 788.5 μg/g* | 100 μg/g* | <0.001 | 79/97 | 98/76 | Lateral flow assay (Buhlmann) | |
| 274 μg/g | 1211.9 μg/g* | 101.8 μg/g* | <0.001 | 77/97 | 98/75 | ELISA (Buhlmann) | ||||||
| Yamamoto et al. (98) | Japan | - | 20 | 12 mons | 170 μg/g | - | - | - | 83/93 | -/- | ELISA (Manufacturer not specified) | |
| Orlando et al. (99) | Italy | 38 | 50 | 3 mons | 200 mg/L | - | - | - | 63/75 | 70/68 | ELISA (Calprest) | |
| Lactoferrin | ||||||||||||
| Wright et al. (89) | Australia and New Zealand | 36 | 135 | 18 mons | 3.4 μg/g | 5.7 μg/g | 1.6 μg/g | 0.007 | 70/68 | 53/81 | ELISA (TechLab) | |
| Lopes et al. (90) | Portugal | 45* | 99 | 25 mons# | 7.25 μg/g | 23.27 μg/g | 2 μg/g | <0.001 | 74/68 | 61/91 | ELISA (TechLab) | |
| ∧Yamamoto et al. (96) | Japan | 32* | 20 | 12 mons | 125 μg/g | 161.4 μg/g* | 83.7 μg/g* | 0.02 | 70/60 | 64/67 | Colloidal gold agglutination assay (Alfresa Pharma Corp.) | |
| Yamamoto et al. (98) | Japan | - | 20 | 12 mons | 140 μg/g | - | - | - | 67/71 | -/- | Colloidal gold agglutination assay (Manufacturer not specified) | |
| S100A12 | ||||||||||||
| Wright et al. (89) | Australia and New Zealand | 36 | 135 | 18 mons | 10.5 μg/g | 2.0 μg/g | 0.8 μg/g | 0.188 | 91/12 | 35/71 | ELISA (In-house) | |
Majority of the studies have examined the use of fecal biomarkers for prediction of endoscopic recurrence, except the study performed by Yamamoto et al. (96)
which was on clinical recurrence. Time-interval: median
or maximum follow up period. Concentrations of fecal markers in patients with and without POR are expressed as mean
or median. Age of patients are presented as mean (*) or median. Studies on pediatric patients are in italic. IBD, inflammatory bowel disease; CD, Crohn's disease; UC, ulcerative colitis; POR, post-operative recurrence; CRP, C-reactive protein; PPV, positive predictive value; NPV, negative predictive value; -, information not available.