International Journal of Colorectal Disease

, Volume 22, Issue 4, pp 429–437

Calprotectin and lactoferrin in the assessment of intestinal inflammation and organic disease

Authors

    • Department of Surgical and Gastroenterological SciencesUniversity of Padua
    • Divisione di GastroenterologiaOspedale Civile
  • Elisabetta Dal Pont
    • Department of Surgical and Gastroenterological SciencesUniversity of Padua
  • Vincenza Di Leo
    • Department of Surgical and Gastroenterological SciencesUniversity of Padua
  • Antonio Ferronato
    • Department of Surgical and Gastroenterological SciencesUniversity of Padua
  • Walter Fries
    • Department of Internal Medicine and Medical TherapyUniversity of Messina
  • Maria Grazia Vettorato
    • Department of Surgical and Gastroenterological SciencesUniversity of Padua
  • Diego Martines
    • Department of Surgical and Gastroenterological SciencesUniversity of Padua
  • Giacomo Carlo Sturniolo
    • Department of Surgical and Gastroenterological SciencesUniversity of Padua
Original Article

DOI: 10.1007/s00384-006-0159-9

Cite this article as:
D’Incà, R., Dal Pont, E., Di Leo, V. et al. Int J Colorectal Dis (2007) 22: 429. doi:10.1007/s00384-006-0159-9

Abstract

Background and aims

Calprotectin and lactoferrin are specific neutrophil-derived proteins, which can be measured in the feces because they are released by cells in inflammatory conditions. We evaluated the efficacy of calprotectin and lactoferrin in detecting organic disease as assessed by colonoscopy.

Methods

The study comprised 144 patients undergoing colonoscopy for lower gastrointestinal symptoms (abdominal pain, altered bowel habits, and bloody stools) (67), or inflammatory bowel disease activity, or surveillance for dysplasia (77). A single stool sample was assayed for calprotectin and lactoferrin. The proportion of patients correctly diagnosed with each test and the relationship with endoscopic and histological findings were measured.

Results

Fecal excretion of calprotectin significantly correlated with the finding of colonic inflammation at endoscopy, both in ulcerative colitis and in Crohn’s disease (p<0,001 and p<0,008, respectively), while lactoferrin excretion significantly correlated with histological inflammation (p=0.001 and p=0.009 respectively). Recommended cut-off values need to be adjusted in the inflammatory bowel disease group. Overall sensitivity, specificity, positive predictive value, and diagnostic efficacy were 78, 83, 86, and 80% for calprotectin and 80, 85, 87, and 81% for lactoferrin, respectively.

Conclusions

Fecal calprotectin and lactoferrin appear to be equally recommendable as inflammatory disease markers in patients with lower gastrointestinal symptoms. Both tests are needed to accurately discriminate activity in inflammatory bowel disease patients.

Keywords

CalprotectinColon cancerCrohn’s diseaseLactoferrinUlcerative colitis

Copyright information

© Springer-Verlag 2006