Evidence map›Paper›PMID 36140627›Full record

ArticleDiagnostics (Basel, Switzerland)2022

Fecal Calprotectin for Small Bowel Crohn's Disease: Is It a Cutoff Issue?

Cristina Romero-Mascarell, Gloria Fernández-Esparrach, Cristina Rodríguez-De Miguel, Maria Carme Masamunt, Sonia Rodríguez, Jordi Rimola, Miguel Urpí, Gherzon Simon Casanova, Ingrid Ordás, Elena Ricart and 5 more

Open access · goldAbstract read
In one paragraph

Article in Diagnostics (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
2.4field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 1 country.

Cristina Romero-MascarellEndoscopy Unit, Gastroenterology Department, ICMDiM, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain.ORCID 0000-0002-1509-8341
Gloria Fernández-EsparrachEndoscopy Unit, Gastroenterology Department, ICMDiM, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain.
Cristina Rodríguez-De MiguelEndoscopy Unit, Gastroenterology Department, ICMDiM, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain.
Maria Carme MasamuntInflammatory Bowel Disease Unit, Gastroenterology Department, ICMDiM, 08036 Barcelona, Spain.
Sonia RodríguezDepartment of Radiology, Centre de Diagnòstic per la Imatge (CDI), Hospital Clínic Barcelona, University of Barcelona, 08036 Barcelona, Spain.
Jordi RimolaDepartment of Radiology, Centre de Diagnòstic per la Imatge (CDI), Hospital Clínic Barcelona, University of Barcelona, 08036 Barcelona, Spain.
Miguel UrpíEndoscopy Unit, Gastroenterology Department, ICMDiM, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain.
Gherzon Simon CasanovaEndoscopy Unit, Gastroenterology Department, ICMDiM, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain.ORCID 0000-0002-1543-5088
Ingrid OrdásInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, 08036 Barcelona, Spain.ORCID 0000-0001-7632-0340
Elena RicartInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, 08036 Barcelona, Spain.
Berta CaballolInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, 08036 Barcelona, Spain.ORCID 0000-0002-7921-6730
Agnès Fernández-ClotetInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, 08036 Barcelona, Spain.ORCID 0000-0001-7513-0764
Julià PanésInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, 08036 Barcelona, Spain.ORCID 0000-0002-4971-6902
Josep LlachEndoscopy Unit, Gastroenterology Department, ICMDiM, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain.
Begoña González-SuárezEndoscopy Unit, Gastroenterology Department, ICMDiM, Hospital Clínic de Barcelona, University of Barcelona, 08036 Barcelona, Spain.ORCID 0000-0001-9566-5993
Hospital Clínic de Barcelona · ESCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

(1) Background: Fecal calprotectin (FC) correlates well with colonic inflammatory activity of Crohn’s disease (CD); data about relation of FC and small bowel (SB) lesions are still contradictory. The main aim was to analyze the relationship between FC levels and SB inflammatory activity in patients with established or suspected Crohn’s disease, assessed by small bowel capsule endoscopy (SBCE) or magnetic resonance enterography (MRE). (2) Methods: Two cohorts of patients were included: 1. Prospective data were collected from patients with established or suspected CD who underwent SBCE and FC (Cohort A); 2. A retrospective cohort of patients who underwent MRE and FC determination (Cohort B). Different cutoffs for FC were tested in both cohorts. (3) Results: 83 patients were included and 66 were finally analyzed. A total of 69.6% had SB lesions seen by SBCE (n = 25) or MRE (n = 21). FC mean levels were 605.74 + 607.07 μg/g (IQ range: 99.00−878.75), being significantly higher in patients with SB lesions compared to patients without lesions (735.91 + 639.70 μg/g (IQ range: 107.75−1366.25) vs. 306.35 + 395.26 μg/g (IQ range: 78.25−411.0), p < 0.005). For cohort A, 25 out of 35 patients had SB lesions and a significant correlation between Lewis Score and FC levels was achieved (R2: 0.34; p = 0.04). FC sensitivity (S), specificity (E), positive predictive value (PPV), and negative predictive values (NPV) for predicting SB lesions were 80%, 50%, 80%, and 50%, respectively, for FC > 100 µg/g. For cohort B, inflammatory SB activity, measured by MaRIA score, was detected in 21 out of 31 patients (67.7%). Patients with positive findings in MRE had significantly higher values of FC than those with no lesions (944.9 + 672.1 µg/g vs. 221 + 212.2 µg/g, p < 0.05). S, E, PPV, and NPV of FC were 89%, 50%, 77.2%, and 71.4% for FC levels > 100 µg/g. The higher sensitivity and specificity of the FC levels for the detection of SB lesions with SBCE and MRE was obtained for an FC cutoff >265 μg/g and >430 μg/g, respectively. (4) Conclusions: FC has a good correlation with the presence of SB lesions, assessed by SBCE and MRE, in patients with established or suspected Crohn’s disease. However, the ideal cutoff is here proven to be higher than previously reported. Multicenter and large prospective studies are needed in order to establish definitive FC cutoff levels.

Indexed as

Crohn’s diseasefecal calprotectininflammatory bowel diseasemagnetic resonance enterographysmall bowel capsule endoscopy

Identifiers

PMID36140627
PMCPMC9497577
OpenAlexW4296095555

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.