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Effect of Disease Extent on Leucine-Rich α2-Glycoprotein as a Marker for Endoscopic Mucosal Healing in Patients With
Shogo Kitahata1, Mai Saito1, Yuka Kimura1
1Gastroenterology Center, Ehime Prefectural Central Hospital Matsuyama Ehime Japan.
Aims:
To determine whether the performance of leucine-rich α2-glycoprotein (LRG) as a biomarker for disease activity in patients with ulcerative colitis (UC) may depend on the extent of the disease.
Methods And Results:
We evaluated the correlation between various biomarkers, including the serum biomarker LRG, and endoscopic activity in 171 patients with UC. Patients were categorized into two groups based on disease extent: patients with pancolitis and those with left-sided colitis and proctitis. LRG demonstrated similar diagnostic accuracy compared to fecal markers in patients with UC exhibiting pancolitis (area under the curve [AUC] for predicting endoscopic mucosal healing: LRG, 0.92; fecal immunochemical testing [FIT], 0.95; and fecal calprotectin [Fcal], 0.96) (FIT vs. LRG, p = 0.886; Fcal vs. LRG, p = 0.412). Conversely, for patients with left-sided colitis and proctitis, fecal markers outperformed LRG in predicting endoscopic mucosal healing (AUC: LRG, 0.66; FIT, 0.94; and Fcal, 0.92) (FIT vs. LRG, p < 0.001; Fcal vs. LRG, p = 0.004).
Conclusion:
Our results support selecting biomarkers according to disease extent for the management of inflammatory bowel disease. In patients with UC and pancolitis, LRG is a viable alternative when fecal samples are not feasible. Conversely, for patients with left-sided colitis and proctitis, fecal markers with high diagnostic accuracy are recommended.
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