Monoclonal antibody testing for fecal calprotectin is superior to polyclonal testing of fecal calprotectin and lactoferrin to identify organic intestinal disease in patients with abdominal discomfort

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• 作者：Emanuel Burri^a ; ^b ; ^{burrie@uhbs.ch} ; ^{emanuel.burri@gmail.com} ; Michael Manz^a ; ^{michael.manz@claraspital.ch} ; Claude Rothen^c ; ^{c.rothen@labor-rothen.ch} ; Livio Rossi^a ; ^{livio.rossi@hin.ch} ; Christoph Beglinger^a ; ^{beglinger@tmr.ch} ; Frank Serge Lehmann^a ; ^{fslehmann@hin.ch}
• 关键词：IBS ; Irritable bowel syndrome ; IBD ; Inflammatory bowel disease ; ELISA ; enzyme-linked immunosorbent assay ; EK-CAL ; Fecal calprotectin ELISA by B&uuml ; hlmann Laboratories AG ; Switzerland ; PhiCal ; Fecal calprotectin ELISA by Calpro AS ; Norway ; IBD-Scan ; Fecal
• 刊名：Clinica Chimica Acta
• 出版年：2013
• 出版时间：1 February, 2013
• 年：2013
• 卷：416
• 期：Complete
• 页码：41-47
• 全文大小：869 K

文摘

Background and aims

Fecal calprotectin and lactoferrin are sensitive markers of mucosal inflammation. We compared three different assays in their ability to identify patients with organic intestinal disease.

Methods

In a post-hoc analysis of a prospective study, we examined 405 unselected patients with abdominal complaints referred for endoscopy to the University Hospital Basel, Switzerland. Calprotectin (EK-CAL, B¨¹hlmann Laboratories, Switzerland; PhiCal, Calpro AS, Norway) and lactoferrin (IBD-Scan, Techlab, USA) were measured using enzyme-linked immunosorbent assays. The presence of a clinically significant endoscopic finding was the primary endpoint of the study. Final diagnoses were adjudicated blinded to calprotectin values.

Results

The prevalence of organic intestinal disease was 35.3 % . Receiver operating characteristics analysis calculated an area under the curve (AUC) for EK-CAL of 0.918, which was significantly better than for PhiCal (AUC 0.842, P < 0.001) and IBD-Scan (AUC 0.830, P = 0.003) to identify patients with organic intestinal disease. Overall test accuracy was 88.1 % for EK-CAL, 83.7 % for PhiCal, and 81.3 % for IBD-Scan. Optimal cut-off value calculated for PhiCal and IBD-Scan were lower than recommended by the manufacturer.

Conclusions

Monoclonal testing of calprotectin is superior to both polyclonal calprotectin testing and fecal lactoferrin in identifying symptomatic patients with organic intestinal disease.