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Research Article Open access CC BY 4.0

Can Noninvasive Tests Substitute Endoscopy for Diagnosis of Colonic Diseases?

Mohamed Mahmoud Zaki, Asem Elfert, Hanan Soliman, Nehad Hawash

Asian Journal of Advanced Research and Reports · pp. 64–73 · Published 3 Dec 2022

10.9734/ajarr/2022/v16i12449

Abstract

Background and Aims: Fecal calprotectin was approved as a non-invasive screening tool for organic colonic diseases. The aim of this study was to evaluate fecal calprotectin and inflammatory indices as non-invasive markers for diagnosing and differentiating inflammatory bowel diseases (IBD) and colorectal cancer (CRC) in comparison to irritable bowel syndrome (IBS) in a cohort of Egyptian patients. Methods: In this cross-sectional study, fecal calprotectin, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and systemic inflammatory index (SII) were assessed in 40 IBD patients, 40 CRC patients, and 20 IBS patients. Results: Fecal calprotectin was significantly higher in IBD and CRC groups compared to IBS control group (P= 0.018 and 0.022 respectively), with no significant difference between IBD and CRC groups. PLR, NLR and SII showed no significant differences between the 3 studied groups (P= 0.469, 0.101 and 0.84 respectively). At a cut-off value 113, fecal calprotectin had the ability to differentiate CRC patients from IBS patients with 75% sensitivity and 60% specificity, while At cut-off value of 116, fecal calprotectin had the ability to differentiate IBD patients from IBS patients with 67.5% sensitivity and 65% specificity. Conclusion: Inflammatory indices tested in our study (PLR, NLR, SII) showed no role for the differentiation between IBD, CRC, and IBS. Fecal calprotectin should be used with caution as a primary step for screening of colonic diseases as it cannot differentiate IBD from CRC. It has only moderate sensitivity in differentiating IBD and CRC from IBS. Unfortunately, neither fecal calprotectin nor inflammatory indices can substitute endoscopy in the screening or diagnosis of IBD and CRC.

Colorectal cancer inflammatory bowel disease irritable bowel syndrome fecal calprotectin systemic inflammatory index

References (35)

  1. 1 Colorectal cancer [DOI]
  2. 2 Systemic Immune-Inflammation Index Predicts Prognosis of Patients after Curative Resection for Hepatocellular Carcinoma [DOI]
  3. 3 Colorectal cancer [DOI]
  4. 4 The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: Definitions and diagnosis [DOI]
  5. 5 The inflammatory pathogenesis of colorectal cancer [DOI]
  6. 6 Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis [DOI]
  7. 7 Intestinal barrier dysfunction in inflammatory bowel diseases [DOI]
  8. 8 World Gastroenterology Organization Practice Guidelines for the Diagnosis and Management of IBD in 2010 [DOI]
  9. 9 The role of inflammation in irritable bowel syndrome (IBS) [DOI]
  10. 10 Reference values for white blood-cell-based inflammatory markers in the Rotterdam Study: a population-based prospective cohort study [DOI]
  11. 11 Role of faecal calprotectin as non-invasive marker of intestinal inflammation [DOI]
  12. 12 Irritable bowel syndrome: Diagnosis and pathogenesis [DOI]
  13. 13 Value of symptoms and additional diagnostic tests for colorectal cancer in primary care: systematic review and meta-analysis [DOI]
  14. 14 The systemic immune‐inflammation index is associated with an increased risk of incident cancer—A population‐based cohort study [DOI]
  15. 15 Preoperative anemia in colorectal cancer: relationships with tumor characteristics, systemic inflammation, and survival [DOI]
  16. 16 Recent trends in the age at diagnosis of colorectal cancer in the US National Cancer Data Base, 2004‐2015 [DOI]
  17. 17 Colonoscopic screening is associated with reduced Colorectal Cancer incidence and mortality: a systematic review and meta-analysis [DOI]
  18. 18 Elevated systemic immune inflammation index level is associated with disease activity in ulcerative colitis patients [DOI]
  19. 19 Colonoscopy for Colorectal Cancer Screening [DOI]
  20. 20 Neopterin Is a Novel Reliable Fecal Marker as Accurate as Calprotectin for Predicting Endoscopic Disease Activity in Patients with Inflammatory Bowel Diseases [DOI]
  21. 21 Diagnostic yield of colonoscopy based on symptoms [DOI]
  22. 22 The relationship between the neutrophil–lymphocyte ratio and disease activity in patients with ulcerative colitis [DOI]
  23. 23 Diagnosis and management of IBS in adults.
  24. 24 Colorectal cancer in South Africa: An assessment of disease presentation, treatment pathways and 5-year survival [DOI]
  25. 25 Effective immune-inflammation index for ulcerative colitis and activity assessments [DOI]
  26. 26 Relationship Between Systemic Immune-Inflammation Index and Irritable Bowel Syndrome [DOI]
  27. 27 The role of faecal calprotectin in diagnosis and staging of colorectal neoplasia: a systematic review and meta-analysis [DOI]
  28. 28 Clinical Performance of a Novel LIAISON Fecal Calprotectin Assay for Differentiation of Inflammatory Bowel Disease From Irritable Bowel Syndrome [DOI]
  29. 29 Clinico-Epidemiological Characteristics of Patients With Inflammatory Bowel Disease in Egypt: A Nationwide Multicenter Study [DOI]
  30. 30 Irritable Bowel Syndrome and the Menstrual Cycle [DOI]
  31. 31 Rates of New or Missed Colorectal Cancers After Colonoscopy and Their Risk Factors: A Population-Based Analysis [DOI]
  32. 32 Local calprotectin production in colorectal cancer and polyps—active neutrophil recruitment in carcinogenesis [DOI]
  33. 33 Fecal calprotectin Level in patients with IBD and noninflammatory disease of colon: a study in Babol, Northern, Iran.
  34. 34 Lymphopenia in Inflammatory Bowel Disease Patients on Immunosuppressive Medications [DOI]
  35. 35 Diagnostic value of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and mean thrombocyte volume in irritable bowel syndrome-constipation according to rome IV criteria [DOI]

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