Juvenile Polyps in Bangladeshi Children and Their Association with Fecal Calprotectin as a Biomarker
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Purpose: Colonoscopy is considered the most reliable method for the diagnosis of juvenile polyps. However, colonoscopic screening is an invasive and expensive procedure. Fecal calprotectin (FCP), a marker of intestinal inflammation, has been shown to be elevated in patients with polyps. Therefore, this study aimed to evaluate FCP as a screening biomarker for the diagnosis of juvenile polyps. Methods: This cross-sectional, observational study was conducted at the Pediatric Gastroenterology and Nutrition Department, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. For children with polyps, colonoscopic polypectomy and histopathology were performed. FCP levels were analyzed before and 4 weeks after polypectomy in all patients. Information was recorded in a datasheet and analyzed using the computer-based program SPSS. Results: The age of the children was between 2.5 and 12 years. Approximately 93% of the polyps were found in the rectosigmoid region. Children with juvenile polyps had elevated levels of FCP before polypectomy that subsequently normalized after polypectomy. The mean FCP levels before and after polypectomy were 277±247 μg/g (range, 80–1,000 μg/g) and 48.57±38.23 μg/g (range, 29–140 μg/g) (p<0.001), respectively. The FCP levels were significantly higher in patients with multiple polyps than in those with single polyps. Moreover, mean FCP levels in patients with single and multiple polyps were 207.6±172.4 μg/ g and 515.4±320.5 μg/g (p<0.001), respectively. Conclusion: Colonic juvenile polyps were found to be associated with elevated levels of FCP that normalized after polypectomy. Therefore, FCP may be recommended as a noninvasive screening biomarker for diagnosis of colonic juvenile polyps.
Abstract
Purpose: Colonoscopy is considered the most reliable method for the diagnosis of juvenile polyps. However, colonoscopic screening is an invasive and expensive procedure. Fecal calprotectin (FCP), a marker of intestinal inflammation, has been shown to be elevated in patients with polyps. Therefore, this study aimed to evaluate FCP as a screening biomarker for the diagnosis of juvenile polyps. Methods: This cross-sectional, observational study was conducted at the Pediatric Gastroenterology and Nutrition Department, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. For children with polyps, colonoscopic polypectomy and histopathology were performed. FCP levels were analyzed before and 4 weeks after polypectomy in all patients. Information was recorded in a datasheet and analyzed using the computer-based program SPSS. Results: The age of the children was between 2.5 and 12 years. Approximately 93% of the polyps were found in the rectosigmoid region. Children with juvenile polyps had elevated levels of FCP before polypectomy that subsequently normalized after polypectomy. The mean FCP levels before and after polypectomy were 277±247 μg/g (range, 80–1,000 μg/g) and 48.57±38.23 μg/g (range, 29–140 μg/g) (p<0.001), respectively. The FCP levels were significantly higher in patients with multiple polyps than in those with single polyps. Moreover, mean FCP levels in patients with single and multiple polyps were 207.6±172.4 μg/ g and 515.4±320.5 μg/g (p<0.001), respectively. Conclusion: Colonic juvenile polyps were found to be associated with elevated levels of FCP that normalized after polypectomy. Therefore, FCP may be recommended as a noninvasive screening biomarker for diagnosis of colonic juvenile polyps.
참고문헌 (34)
- Yachha SK, "Gastrointestinal bleeding in children", J Gastroenterol Hepatol, 11, pp.903~907 (1996)
- Gelb AM, "Rectal and colonic polyps occurring in young people", N Y State J Med, 62, pp.513~518 (1962)
- Olafsdottir I, "Value of fecal calprotectin as a biomarker for juvenile polyps in children investigated with colonoscopy", J Pediatr Gastroenterol Nutr, 62, pp.43~46 (2016)
- Holgersen LO, "Colonoscopy for rectal bleeding in childhood", J Pediatr Surg, 13, pp.83~85 (1978)
- Cynamon HA, "Diagnosis and management of colonic polyps in children", J Pediatr, 114, pp.593~596 (1989)
- 박재홍, "Role of colonoscopy in the diagnosis and treatment of pediatric lower gastrointestinal disorders", Clinical and Experimental Pediatrics, 53(9), pp.824~829 (2010), 대한소아청소년과학회
- Poddar U, "Colonic polyps : experience of 236 Indian children", Am J Gastroenterol, 93, pp.619~622 (1998)
- Fox VL, "Juvenile polyps : recurrence in patients with multiple and solitary polyps", Clin Gastroenterol Hepatol, 8, pp.795~799 (2010)
- Giardiello FM, "Colorectal neoplasia in juvenile polyposis or juvenile polyps", Arch Dis Child, 66, pp.971~975 (1991)
- Mestre JR, "The changing pattern of juvenile polyps", Am J Gastroenterol, 81, pp.312~314 (1986)
- Poullis A, "Emerging role of calprotectin in gastroenterology", J Gastroenterol Hepatol, 18, pp.756~762 (2003)
- Fagerhol MK, "A radioimmunoassay for a granulocyte protein as a marker in studies on the turnover of such cells", Bull Eur Physiopathol Respir, 16, pp.273~282 (1980)
- Steinbakk M, "Antimicrobial actions of calcium binding leucocyte L1 protein, calprotectin", Lancet, 336, pp.763~765 (1990)
- Costa F, "Role of faecal calprotectin as non-invasive marker of intestinal inflammation", Dig Liver Dis, 35, pp.642~647 (2003)
- Pezzilli R, "Fecal calprotectin levels in patients with colonic polyposis", Dig Dis Sci, 53, pp.47~51 (2008)
- Johne B, "Functional and clinical aspects of the myelomonocyte protein calprotectin", Mol Pathol, 50, pp.113~123 (1997)
- Bjerke K, "Distribution of macrophages and granulocytes expressing L1 protein(calprotectin)in human Peyer’s patches compared with normal ileal lamina propria and mesenteric lymph nodes", Gut, 34, pp.1357~1363 (1993)
- Røseth AG, "Assessment of the neutrophil dominating protein calprotectin in feces. A methodologic study", Scand J Gastroenterol, 27, pp.793~798 (1992)
- Vrabie R, "Noninvasive markers of disease activity in inflammatory bowel disease", Gastroenterol Hepatol(N Y), 10, pp.576~584 (2014)
- McMahon CW, "The role of fecal calprotectin in investigating digestive disorders", J Lab Precis Med, 3, pp.19~ (2018)
- Di Nardo G, "Faecal calprotectin and ultrasonography as non-invasive screening tools for detecting colorectal polyps in children with sporadic rectal bleeding : a prospective study", Ital J Pediatr, 46, pp.66~ (2020)
- Vaos G, "The role of calprotectin in pediatric disease", BioMed Res Int, 2013, pp.542363~ (2013)
- Voganatsi A, "Mechanism of extracellular release of human neutrophil calprotectin complex", J Leukoc Biol, 70, pp.130~134 (2001)
- Montalto M, "Role of fecal calprotectin in gastrointestinal disorders", Eur Rev Med Pharmacol Sci, 17, pp.1569~1582 (2013)
- Mandhan P, "Juvenile colorectal polyps in children : experience in Pakistan", Pediatr Surg Int, 20, pp.339~342 (2004)
- Ko FY, "Intestinal polyps in children and adolescents--a review of 103 cases", Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi, 36, pp.197~202 (1995)
- Thakkar KH, "M1575 : the frequency and determinants of polyps in children : results from a national endoscopic database", Gastrointest Endosc, 71, pp.AB258~ (2010)
- Latt TT, "Rectal bleeding and polyps", Arch Dis Child, 69, pp.144~147 (1993)
- Pillai RB, "Colonic polyps in children: frequently multiple and recurrent", Clin Pediatr(Phila), 37, pp.253~257 (1998)
- Wei C, "Colorectal polyps in children : a retrospective study of clinical features and the value of ultrasonography in their diagnosis", J Pediatr Surg, 47, pp.1853~1858 (2012)
- Rathi C, "Clinical, endoscopic, and pathologic characteristics of colorectal polyps in Indian children and adolescents", Indian J Gastroenterol, 34, pp.453~457 (2015)
- Pauley-Hunter RJ, "Fecal calprotectin and pediatric juvenile polyps", J Pediatr Gastroenterol Nutr, 60, pp.30~31 (2015)
- Khan F, "Fecal calprotectin as a future screening tool for large juvenile polyps", Glob Pediatr Health, 2 (2015)
- Teitelbaum JE, "Fecal calprotectin in juvenile polyposis coli", J Clin Gastroenterol, 44, pp.593~ (2010)