lactoferrin and Colonic-Diseases

To evaluate prospectively usefulness of fecal lactoferrin (Lf) and fecal hemoglobin (Hb) in the diagnosis of colorectal diseases.. Fecal Lf and Hb were measured using ELISA in 872 patients before they underwent colorectal endoscopy.. Lf was positive in 18 (50%) of 36 patients with colorectal cancer, 25 (15.9%) of 157 with colorectal polyps, 29 (46.8%) of 62 with ulcerative colitis, and 25 (62.5%) of 40 (62.5%) with Crohn's disease. The Hb-positive rates were 50%, 12.1%, 41.9% and 32.5%, respectively. Of the 318 patients free of abnormalities by colorectal endoscopy, Lf was positive in 29 (9.1%) and Hb was positive in 15 (4.7%). Among patients with Crohn's disease, the Lf-positive rate was significantly higher than the Hb-positive rate. If either high Lf or Hb levels were considered positive, the positive rates rose to 61.1%, 51.6%, and 67.5% in the colorectal cancer group, ulcerative colitis group, and Crohn's disease group, respectively. If both high Lf and Hb levels were rated positive, the positive predictive values (PPV) were 21% for colorectal cancer, 33% for ulcerative colitis, and 17% for Crohn's disease, and PPV of high Hb level alone was 18%, 25% and 13%, respectively.. Fecal Lf and Hb were found useful in the detection of colorectal diseases, and the combination of the two measurements appears to increase the sensitivity and efficacy of diagnosis.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers; Child; Colonic Diseases; Colorectal Neoplasms; Endoscopy, Gastrointestinal; Feces; Hemoglobins; Humans; Lactoferrin; Middle Aged; Predictive Value of Tests; Prospective Studies; Rectal Diseases; Sensitivity and Specificity

This prospective pilot study was conducted to compare the usefulness of measuring fecal lactoferrin (Lf) to that of fecal occult blood (FOB) test for detection of colorectal diseases.. The subjects were 351 patients who underwent colonoscopy. A fecal sample was obtained on the day before colonoscopy. Fecal Lf was measured by enzyme-linked immunosorbent assay. The FOB test was performed by combined assay (latex agglutination) of hemoglobin and transferrin.. The specificities of the fecal Lf and FOB tests were the same (88.7%). For patients with colorectal cancer (13), colorectal polyp (69), ulcerative colitis (18), Crohn's disease (13), non-specific colitis (8), internal hemorrhoids (60), colon diverticulum (27), and miscellaneous diseases of the colon (10), the rates of positivity for fecal Lf were 7/13, 14/69, 12/18, 7/13, 4/8, 22/60, 8/27, and 6/10, respectively. The corresponding rates for FOB were 8/13, 12/69, 11/18, 4/13, 4/8, 9/60, 2/27, and 1/10. For patients with internal hemorrhoids, the rate of positivity for fecal Lf was significantly higher than that for FOB. In other disease groups, there was no significant difference in the rate of positivity between fecal Lf and FOB.. These findings suggest that measurement of fecal Lf is as useful as FOB in detecting colorectal diseases.

Topics: Colonic Diseases; Colonoscopy; Enzyme-Linked Immunosorbent Assay; Feces; Hemoglobins; Humans; Lactoferrin; Occult Blood; Pilot Projects; Prospective Studies; Rectal Diseases; Sensitivity and Specificity; Transferrin