Eur Rev Med Pharmacol Sci 2006; 10 (1): 17-22

The role of calprotectin in predicting endoscopic post-surgical recurrence in asymptomatic Crohn’s disease: a comparison with ultrasound

A. Orlando, I. Modesto, F. Castiglione*, L. Scala, D. Scimeca, A. Rispo*, S. Teresi**, F. Mocciaro, V. Criscuoli, C. Marrone, P. Platania#, T. De Falco*, S. Maisano, N. Nicoli#, M. Cottone

Department of Internal Medicine, “V. Cervello” Hospital – Palermo (Italy) *Department of Gastroenterology, Federico II University – Naples (Italy) **Clinical Pathology laboratory, “G. Di Cristina” Hospital – Palermo (Italy) #Department of General Surgery 1th, “V. Cervello” Hospital – Palermo (Italy)


Background and Objectives: Faecal calprotectin is predictive of clinical relapse in inflammatory bowel disease and ultrasound is sensitive in detecting its post-surgical recurrence. However, no data regarding the role of calprotectin in predicting post-surgical recurrence in asymptomatic Crohn’s disease are available.
The aim of this study was to prospectively evaluate the role of calprotectin as a predictive marker for one year post-surgical endoscopic recurrence in comparison with ultrasound in patients with asymptomatic Crohn’s disease.

Material and Methods: We consecutively enlisted 50 patients who had undergone a resection for Crohn’s disease. Faecal calprotectin was analysed and ultrasound were performed at the third month, and a colonoscopy after one year. The sensitivity and specificity of these two techniques were evaluated using endoscopic findings as a golden standard. A Receiver Operator Curve (ROC) curve was plotted, in order to identify the best-cut off value for calprotectin.

Results: 39 out of 50 patients were evaluated by performing a colonoscopy after one year; 19 patients had an endoscopic recurrence after one year. Calprotectin sensitivity and specificity were calculated for 5 different cut-off values; the best cut-off value for calprotectin sensitivity (63%) and specificity (75%) was > 200 mg/L. The US sensitivity and specificity at the third month were 26% and 90% respectively.

Conclusions: When performed three months after surgery ultrasound is more specific than calprotectin in predicting endoscopic recurrence. Faecal calprotectin at a dosage > 200 mg/L seems to have a better sensitivity than ultrasound. Values of calprotectin > 200 mg can be an indication to colonoscopy in the group of patients with negative ultrasound in order to detect early recurrence.

To cite this article

A. Orlando, I. Modesto, F. Castiglione*, L. Scala, D. Scimeca, A. Rispo*, S. Teresi**, F. Mocciaro, V. Criscuoli, C. Marrone, P. Platania#, T. De Falco*, S. Maisano, N. Nicoli#, M. Cottone
The role of calprotectin in predicting endoscopic post-surgical recurrence in asymptomatic Crohn’s disease: a comparison with ultrasound

Eur Rev Med Pharmacol Sci
Year: 2006
Vol. 10 - N. 1
Pages: 17-22