P157 Fecal calprotectin correlates to endoscopic and histologic remission in ulcerative colitis: a prospective study
Bibliographic record
Abstract
Background: Endoscopic healing (EH), has become the target endpoint of successful ulcerative colitis (UC) management while the role of histology remains to be clarified. Clinical and biochemical markers are not sufficient to predict which UC patients are in EH. Fecal calprotectin (FC) has been demonstrated to be useful surrogate marker, however, there has not been a consensus for cut off values for FC for endoscopic and histologic remission. Methods: Our prospective cohort study recruited patients with UC in clinical remission who were being followed at the McGill IBD Center between 2013–2016. Patients were recruited if they had clinical remission (partial Mayo score of ≤2) and were undergoing colonoscopy for disease reassessment. At the time of colonoscopy, fecal calprotectin (FC) was collected, as well as full and endoscopic Mayo score, Geboes histology score and record of basal plasmacytosis. Results: 163 patients were recruited (88 males, 75 females; mean age 49 years; IQR 39–59). Based on endoscopic scores, 65% (n=106), 24% (n=39), 11% (n=18) patients were Mayo 0, 1, 2 respectively. There was a statistically significant difference in fecal calprotectin based on endoscopic mayo score (p<0.0001). The area under the curve (AUC) in receiver operator characteristic (ROC) analysis of FC to predict Mayo 0 (from Mayo 1–2) was 0.747 (CI 95% 0.65–0.83, p<0.01) with a cut off value of FC 150mcg/g yielding 65% sensitivity and 72% specificity. Table 1. Fecal calprotectin and mayo endoscopic score 0 (versus Mayo 1–2) Similarly, there was a statistically significant difference between fecal calprotectin based on histologic Geboes score and presence or absence of basal plasmacytosis (p=0.005). The AUC in ROC analysis of FC to predict Geboes <3.1 (remission) was 0.582 (CI 95% 0.481–0.683, p=0.119). The AUC in ROC analysis of FC to predict basal plasmacytosis was 0.64 (CI 95% 0.51–0.766, p=0.02), with a cut off value of FC 140 mcg/g yielding 60% sensitivity and 72% specificity. Table 2. Fecal calprotectin and basal plasmacytosis Conclusions: Our study demonstrates that fecal calprotectin below 150 mcg/g predicts endoscopic Mayo 0. In addition to correlating with the endoscopic score, fecal calprotectin below 140 mcg/g correlates with absence of basal plasmacytosis. Using non-invasive testing, these predictive values have potential to identify patients with ulcerative colitis in remission, but further validation is needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".