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KMID : 0191120220370090072
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Journal of Korean Medical Science
2022 Volume.37 No. 9 p.72 ~ p.72
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Potential Utility of Fecal Calprotectin in Discriminating Colorectal Polyps From Other Major Etiologies in Children Presenting With Isolated Hematochezia
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Kim Yu-Bin
Kim Ju-Young
Choi Su-Jin
Kim Hyun-Jin
Lee Yoo-Min
Lee Yoon
Jang Hyo-Jeong
Lee Eun-Hye
Lee Kyung-Jae
Kim Soon-Chul
Choi So-Yoon
Kang Yun-Koo
Yi Dae-Yong
Choi You-Jin
Choe Byung-Ho
Kang Ben
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Abstract
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Background: Colorectal polyps are the most common cause of isolated hematochezia in children, which requires a colonoscopy for diagnosis. We aimed to investigate the potential utility of fecal calprotectin (FC) in assessing colorectal polyps detected by colonoscopy among children presenting with isolated hematochezia.
Methods: Pediatric patients of the age of < 18 years who had undergone both colonoscopy and FC tests for isolated hematochezia from June 2016 to May 2020 were included in the present multicenter, retrospective, cross-sectional study. Comparative analysis was conducted between major causes of isolated hematochezia and FC cut-offs for discriminating colorectal polyps were explored.
Results: A total 127 patients were included. Thirty-five patients (27.6%) had colorectal polyps, followed by anal fissure (14.2%), ulcerative colitis (UC; 12.6%), and others. A significant difference in FC levels was observed between patients with colorectal polyps (median, 278.7 mg/kg), anal fissures (median, 42.2 mg/kg), and UC (median, 981 mg/kg) (P < 0.001). According to receiver operating characteristic curve analysis, among patients diagnosed with colorectal polyp or anal fissure, the most accurate FC cut-off for discriminating colorectal polyps from anal fissures on colonoscopy was 225 mg/kg (sensitivity, 59.4%; specificity, 94.4%; positive predictive value [PPV], 95.0%; negative predictive value [NPV], 56.7%; area under the curve [AUC], 0.8; 95% confidence interval [CI], 0.678?0.923; P < 0.001), while among patients diagnosed with colorectal polyp or UC, the most accurate FC cut-off for discriminating colorectal polyps from UC on colonoscopy was 879 mg/kg (sensitivity, 81.2%; specificity, 56.2%; PPV, 78.8%; NPV, 60.0%; AUC, 0.687; 95% CI, 0.521?0.852; P < 0.001).
Conclusion: FC may assist in assessing the cause of lower gastrointestinal tract bleeding in children who present with isolated hematochezia.
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KEYWORD
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Fecal Calprotectin, Colorectal Polyp, Anal Fissure, Ulcerative Colitis, Hematochezia
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