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Colorimetric correcting for sample concentration in stool samples.

Joris R Delanghe1, Jan Van Elslande1, Maaike J Godefroid1

  • 1Labo Maenhout, Waregem, Belgium.

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|September 20, 2024
PubMed
Summary
This summary is machine-generated.

Correcting fecal immunochemical tests (FIT) and fecal calprotectin results using stercobilin can improve interpretation. This method accounts for stool sample dilution, leading to more accurate detection of colorectal cancer and intestinal inflammation.

Keywords:
calprotectinfecal occult bloodpre-analytical errorstercobilin

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Area of Science:

  • Clinical Chemistry
  • Gastroenterology
  • Biochemistry

Background:

  • Fecal immunochemical tests (FIT) and fecal calprotectin are standard for colorectal cancer screening and monitoring intestinal inflammation, respectively.
  • Pre-analytical issues, particularly variable stool water content, challenge the accuracy of these tests.
  • Currently, no reference analytes exist to standardize results based on sample hydration.

Purpose of the Study:

  • To investigate stercobilin as a reference analyte for correcting pre-analytical variations in stool samples.
  • To assess the impact of stercobilin-based correction on the interpretation of FIT and fecal calprotectin results.

Main Methods:

  • Stercobilin, a stable heme metabolite, was assayed in stool extracts using colorimetry (I index).
  • Serum indices (H, I, L) and bilirubin concentration were measured using the Atellica Platform.
  • The median I-index was used to correct for stool sample dilution.

Main Results:

  • Stercobilin concentration showed high inter-individual variation, enabling correction for sample dilution.
  • Correcting FIT results increased positive tests from 9.3% to 11.7%.
  • Fecal calprotectin correction yielded 3.1% more positive and 7.7% more negative results.

Conclusions:

  • Stercobilin-based correction is applicable for FIT and fecal calprotectin, except in obstructive jaundice.
  • Adjusting results for sample dilution enhances the interpretation of common fecal analytes.
  • This approach may lead to more precise clinical decision-making for colorectal cancer and inflammatory bowel disease.