Accuracy of Faecal Immunochemical Test to Predict Endoscopic and Histological Healing in Ulcerative Colitis: A Prospective Study Based on Validated Histological Scores
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AbstractBackground and Aims:

Endoscopic and histological healing are associated with improved clinical outcomes in ulcerative colitis [UC]. We aimed to investigate the predictive value of faecal immunochemical test [FIT] for endoscopic and histological healing in UC.

Methods:

We measured quantitative FIT and faecal calprotectin [FC] in 140 consecutive UC patients who underwent colonoscopy. We assessed the diagnostic accuracy of FIT for predicting endoscopic healing using the Mayo endoscopic subscore [MES 0/1] and for histological healing using the Geboes score [< 2.0] and Nancy index [grade ≤ 1]. The predictive abilities of FIT were compared with those of FC.

Results:

FIT had an area under the curve [AUC] of 0.77 (95% confidence interval [CI] 0.67–0.86, p < 0.001) for endoscopic healing, an AUC of 0.77 [95% CI 0.67–0.86, p < 0.001] using the Geboes score, and 0.77 [95% CI 0.66–0.85, p < 0.001] using the Nancy Index for histological healing. The AUC of FIT was comparable to that of FC for endoscopic healing [p = 0.773] and histological healing [p = 0.767–0.960], and was comparable to colonoscopy for histological healing [p = 0.384–0.673]. FIT < 50 ng/ml predicted endoscopic healing with a sensitivity, specificity, and positive predictive value [PPV] of 72%, 68%, and 82%, respectively, and for histological healing with a sensitivity, specificity, and PPV of 73–75%, 67%, and 78–80%, respectively. Combining FIT with FC led to a higher specificity [90%] for histological healing. Over 85% of patients with FIT < 50 ng/ml and FC < 50 μg/g achieved histological healing.

Conclusions:

FIT is highly sensitive and accurate to predict endoscopic and histological healing in UC. It represents a promising non-invasive tool for monitoring mucosal healing in UC.
Acceptance Date12/07/2017
All Author(s) ListHai Yun Shi, Francis K. L. Chan, Anthony W. H. Chan, Akira Higashimori, Moe Kyaw, Jessica Y. L. Ching, Arthur K. C. Luk, Sunny H. Wong, Justin C. Y. Wu, Joseph J. Y. Sung, Siew C. Ng
Journal nameJournal of Crohn's and Colitis
Year2017
Month9
Volume Number11
Issue Number9
PublisherOxford University Press
Pages1071 - 1077
ISSN1873-9946
eISSN1876-4479
LanguagesEnglish-United Kingdom
KeywordsUlcerative colitis, mucosal healing, faecal immunochemical test

Last updated on 2020-26-03 at 02:23