P381 Role of fecal calprotection in predicting ileocolonic endoscopic recurrence in postoperative Crohn's disease

Abstract

Introduction: Fecal calprotectin nicely correlates with intestinal disease activity in Crohn's disease. It was the aim of this study to evaluate its role in predicting endoscopic recurrence in postoperative Crohn's disease. Material and Methods: 62 patients who underwent ileocolonic resection due to Crohn's diease at the General Hospital of Vienna were prospectively followed up. Ileocolonoscopy was done 6 to 18 months postoperatively and scored after Rutgeerts. Endoscopic recurrence was defined as i2b (at least i2 in terminal ileum) or higher. Endoscopic pictures were reviewed by 2 independent reviewers unaware of the calprotectin results. 5 patients had to be excluded because the terminal ileum was not reached. 57 patients were evaluated. The median age was 41 (range 22 to 68), 32 male (56,1%), 25 female. Montreal Classification: A2 (35%), A3 (65%); L1 (10%), L2 (15%), L3 (67,5%), L4 (7,5); B1 (2,5%), B2 (40%), B3 (57,5%); none had perianal disease. Stool specimens were collected immediately after surgery and every 3 months until colonoscopy. Calprotectin was measured by commercial ELISA (Bühlmann Co, Schönenbuch, Switzerland) in stool. Disease was considered active if fecal calprotectin was .100μg/g stool. Statistical analysis was performed using IBM SPSS 20. Results: Fecal calprotectin collected after a median of 6 months after the surgery (range 3 to 8) was compared with, ileocolonoscopy performed 11 months after surgery (median; range 5 to 16). table1 The sensitivity, specificity, positive predictive value, negative predictive value of increased fecal calprotectin for endoscopic recurrence were 93%, 47%, 61%, and 80% respectively. There was a significant association of increased fecal calprotectin and endoscopic recurrence (Chi-square-test, p=0.001). For CRP (elevated if . 1mg/dl, measured 6 months after operation) the association with endoscopic recurrence was not significant (p=0.374). Conclusion: Fecal calprotectin collected at 6 months after surgery may serve as predictive parameter for endoscopic recurrence of Crohn's disease.