Fecal hemoglobin demonstrated the highest sensitivity and specificity for colorectal cancer detection, significantly outperforming other fecal markers in this clinical validation study.
The clinical validation study at Sapporo Medical University Hospital evaluated the utility of fecal calprotectin (Cp), lactoferrin (Lf), and hemoglobin (Hb) levels in patients with inflammatory bowel disease (IBD) and colorectal tumors using an "all-in-one kit." The study analyzed 104 participants: 25 with ulcerative colitis (UC), 20 with Crohn's disease, 48 with colorectal tumors, and 13 healthy controls.
The study, published in the Journal of Gastroenterology and Hepatology, found that fecal Cp and Lf levels were nearly equivalent in detecting clinical remission in UC patients, with Cp being slightly superior (Cp: sensitivity 93%, specificity 63%; Lf: sensitivity 87%, specificity 63%). In patients with colorectal tumors, including 14 with invasive cancer, fecal Cp (median, 203 µg/g) and Lf (median, 51 µg/g) levels were elevated compared to healthy controls (Cp: median, 127 µg/g; Lf: median, 29 µg/g). Fecal Hb demonstrated the highest sensitivity (78.6%) and specificity (85.1%) for colorectal cancer detection but exhibited relatively low sensitivity for advanced neoplasms.
The researchers concluded that fecal Cp and Lf are effective for assessing clinical activity in UC. However, fecal Hb remains the most effective marker for colorectal cancer screening. Combining fecal Cp and Lf with Hb could enhance the sensitivity for detecting advanced colorectal tumors. This study underscored the potential of using these fecal markers for the noninvasive assessment of IBD and colorectal tumors.
The authors have no conflicts of interest to declare.