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  • 1. Aims and Scope

    Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE

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    Yong Chan Lee Professor of Medicine
    Director, Gastrointestinal Research Laboratory
    Veterans Affairs Medical Center, Univ. California San Francisco
    San Francisco, USA

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    Jong Pil Im Seoul National University College of Medicine, Seoul, Korea
    Robert S. Bresalier University of Texas M. D. Anderson Cancer Center, Houston, USA
    Steven H. Itzkowitz Mount Sinai Medical Center, NY, USA
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Diagnostic Accuracy of Fecal Calprotectin for the Detection of Small Bowel Crohn’s Disease through Capsule Endoscopy: An Updated Meta-analysis and Systematic Review

Eun Suk Jung1 , Sang Pyo Lee1 , Sea Hyub Kae1 , Jung Han Kim2 , Hyeong Su Kim2 , and Hyun Joo Jang1

1Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, and 2Division of Hematology-Oncology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea

Correspondence to:Hyeong Su Kim
ORCID https://orcid.org/0000-0003-0553-9008
E-mail nep2n@hallym.or.kr
Hyun Joo Jang
ORCID https://orcid.org/0000-0003-0553-9008
E-mail jhj1229@hallym.or.kr

Received: August 4, 2020; Revised: September 21, 2020; Accepted: October 27, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Gut and Liver

Published online December 24, 2020

Copyright © Gut and Liver.

Abstract

Background/Aims: The diagnosis of small bowel Crohn’s disease with negative ileocolonoscopic findings has been challenging. Fecal calprotectin (FC) has been used to detect colonic inflammation, but its efficacy for detecting small bowel inflammation is less established. We performed an updated meta-analysis to evaluate the diagnostic accuracy of FC to detect active small bowel inflammation observed during capsule endoscopy.
Methods: We conducted a systematic literature search for studies that evaluated the correlation between small bowel inflammation and FC in patients with suspected/established Crohn’s disease. We calculated the pooled sensitivity, specificity, and diagnostic odds ratios (DORs) and constructed hierarchical summary receiver operating characteristic curves for FC cutoffs of 50, 100, and 200 µg/g.
Results: Fourteen studies were eligible for the final analysis. The DORs of all FC cutoffs were significant. The highest DOR was observed at 100 µg/g (sensitivity, 0.73; specificity, 0.73; and DOR, 7.89) and was suggested as the optimal diagnostic cutoff. If we analyzed only studies that included patients with suspected Crohn’s disease, the DOR was 8.96. If we analyzed only studies that included patients with a Lewis score ≥135 as a diagnostic criterion for active disease, the DOR was 10.90.
Conclusions: FC has significant diagnostic accuracy for detecting small bowel inflammation, and an FC cutoff of 100 µg/g can be used as a tool to screen for small bowel Crohn’s disease.

Keywords: Biomarker, Capsule endoscopy, Fecal calprotectin, Small bowel Crohn’s disease


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Gut and Liver

Published online December 24, 2020

Copyright © Gut and Liver.

Diagnostic Accuracy of Fecal Calprotectin for the Detection of Small Bowel Crohn’s Disease through Capsule Endoscopy: An Updated Meta-analysis and Systematic Review

Eun Suk Jung1 , Sang Pyo Lee1 , Sea Hyub Kae1 , Jung Han Kim2 , Hyeong Su Kim2 , and Hyun Joo Jang1

1Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, and 2Division of Hematology-Oncology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea

Correspondence to:Hyeong Su Kim
ORCID https://orcid.org/0000-0003-0553-9008
E-mail nep2n@hallym.or.kr
Hyun Joo Jang
ORCID https://orcid.org/0000-0003-0553-9008
E-mail jhj1229@hallym.or.kr

Received: August 4, 2020; Revised: September 21, 2020; Accepted: October 27, 2020

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims: The diagnosis of small bowel Crohn’s disease with negative ileocolonoscopic findings has been challenging. Fecal calprotectin (FC) has been used to detect colonic inflammation, but its efficacy for detecting small bowel inflammation is less established. We performed an updated meta-analysis to evaluate the diagnostic accuracy of FC to detect active small bowel inflammation observed during capsule endoscopy.
Methods: We conducted a systematic literature search for studies that evaluated the correlation between small bowel inflammation and FC in patients with suspected/established Crohn’s disease. We calculated the pooled sensitivity, specificity, and diagnostic odds ratios (DORs) and constructed hierarchical summary receiver operating characteristic curves for FC cutoffs of 50, 100, and 200 µg/g.
Results: Fourteen studies were eligible for the final analysis. The DORs of all FC cutoffs were significant. The highest DOR was observed at 100 µg/g (sensitivity, 0.73; specificity, 0.73; and DOR, 7.89) and was suggested as the optimal diagnostic cutoff. If we analyzed only studies that included patients with suspected Crohn’s disease, the DOR was 8.96. If we analyzed only studies that included patients with a Lewis score ≥135 as a diagnostic criterion for active disease, the DOR was 10.90.
Conclusions: FC has significant diagnostic accuracy for detecting small bowel inflammation, and an FC cutoff of 100 µg/g can be used as a tool to screen for small bowel Crohn’s disease.

Keywords: Biomarker, Capsule endoscopy, Fecal calprotectin, Small bowel Crohn’s disease

Gut and Liver

Vol.15 No.3
May, 2021

pISSN 1976-2283
eISSN 2005-1212

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