Abstract
We evaluated the association between endoscopic scores of colonic inflammation and fecal calprotectin (FC), fecal immunochemical occult blood test (FIT), and C-reactive protein (CRP) in patients with ulcerative colitis (UC). Endoscopic scores reflecting the most severe lesion [maximum Mayo Endoscopic Subscore (M-MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS)] and those reflecting the inflammation of the entire colon [sum of MES (S-MES) and Ulcerative Colitis Colonoscopic Index of Severity (UCCIS)] were evaluated. FC, FIT, and CRP were measured, and their association with the four endoscopic scores was evaluated. Endoscopic scores of 78 complete colonoscopies (66 UC patients) were evaluated using the three biomarkers. FC and CRP tended to correlate more strongly with S-MES and UCCIS than with M-MES and UCEIS. In the M-MES 0, 1 group, compared to CRP, FC and FIT showed stronger correlations with S-MES and UCCIS. Conversely, in the M-MES 2, 3 group, only CRP was significantly correlated with each descriptor. CRP more strongly reflects colon-wide mucosal inflammation than FC and allows reliable assessment of inflammation throughout the colon in active UC.
Highlights
We evaluated the association between endoscopic scores of colonic inflammation and fecal calprotectin (FC), fecal immunochemical occult blood test (FIT), and C-reactive protein (CRP) in patients with ulcerative colitis (UC)
The usefulness of FC, FIT, and CRP as biomarkers for UC was examined using the maximum Mayo Endoscopic Subscore (MES) (M-MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS), which show the most severe UC lesions, and the sum of MES (S-MES) and Ulcerative Colitis Colonoscopic Index of Severity (UCCIS), which show the degree of inflammation throughout the entire colon
Compared to CRP, FC and FIT showed a stronger correlation with each endoscopic score
Summary
We evaluated the association between endoscopic scores of colonic inflammation and fecal calprotectin (FC), fecal immunochemical occult blood test (FIT), and C-reactive protein (CRP) in patients with ulcerative colitis (UC). Scoring is performed by applying the sum of descriptors to the calculation formula, allowing the objective evaluation of the inflammatory state of the entire colon, which is highly useful in clinical research. Few reports have shown an association between biomarkers and endoscopic scores for evaluating the entire colon, such as the S-MES and UCCIS. The usefulness of FC, FIT, and CRP as biomarkers for UC was examined using the maximum MES (M-MES) and UCEIS, which show the most severe UC lesions, and the S-MES and UCCIS, which show the degree of inflammation throughout the entire colon. If biomarkers can be confirmed to correlate with colon-wide inflammation in patients with UC, the information may enable the assessment of active disease without the need for colonoscopy, which is associated with an increased risk of perforation in active disease
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