CALPROTECTINA FECAL PARA LA DETECCIÓN DE LA RECURRENCIA POSOPERATORIA DE LA ENFERMEDAD DE CROHN
Palabras clave:
Calprotectina fecal; Enfermedad de Crohn; Recurrencia posoperatoria; Biomarcadores; Ileocolonoscopia; Revisión bibliográficaResumen
DOI: https://doi.org/10.46296/yc.v10i19.1018
Resumen
Introducción: La recurrencia endoscópica tras la resección ileocólica por enfermedad de Crohn puede preceder a los síntomas. La calprotectina fecal (CF) es un biomarcador de inflamación intestinal potencialmente útil para la vigilancia no invasiva. Objetivo: Sintetizar la evidencia sobre capacidad diagnóstica, umbrales e interpretación longitudinal de CF para detectar recurrencia posoperatoria. Métodos: Revisión bibliográfica estructurada de estudios y recomendaciones publicados hasta el 20 de septiembre de 2026. Se examinaron registros de PubMed/MEDLINE, literatura disponible en SciELO y fuentes regionales accesibles mediante BVS; se formuló una estrategia específica para LILACS, cuya ejecución y exportación íntegra quedaron pendientes de validación. La síntesis fue narrativa, sin metaanálisis nuevo. Resultados: En el estudio POCER, CF >100 ug/g mostró sensibilidad de 89%, especificidad de 58% y valor predictivo negativo de 91%. Una revisión de 2018 identificó para 150 ug/g sensibilidad y especificidad agrupadas de 70% y 69%; una síntesis de 2025 estimó 76% y 66%, respectivamente, para 50 ug/g. La utilidad depende del umbral, el riesgo basal, la definición endoscópica y la tendencia de mediciones sucesivas. Conclusiones: CF es útil para estratificar la necesidad de ileocolonoscopia y monitorizar la recurrencia, especialmente cuando permanece baja en pacientes de riesgo reducido. No reemplaza la valoración endoscópica programada ni confirma, por sí sola, la recurrencia.
Palabras claves: Calprotectina fecal; Enfermedad de Crohn; Recurrencia posoperatoria; Biomarcadores; Ileocolonoscopia; Revisión bibliográfica.
Abstract
Background: Endoscopic recurrence after ileocolic resection for Crohn’s disease may precede clinical symptoms. Fecal calprotectin (FC) is a noninvasive marker of intestinal inflammation. Objective: To summarize the diagnostic performance, thresholds, and longitudinal interpretation of FC in postoperative recurrence monitoring. Methods: A structured literature review was conducted using publications available through September 20, 2026. PubMed/MEDLINE records, SciELO literature, and regional material available through the Virtual Health Library were reviewed. A tailored LILACS search strategy was prepared, although full execution and export could not be verified. Evidence was synthesized narratively without a new meta-analysis. Results: A POCER-based analysis reported 89% sensitivity, 58% specificity, and 91% negative predictive value at a cutoff above 100 ug/g. A 2018 meta-analysis reported pooled sensitivity and specificity of 70% and 69% at 150 ug/g, whereas a 2025 review estimated 76% and 66% at 50 ug/g. Performance varied according to threshold, baseline recurrence risk, endoscopic definition, and serial changes. Conclusions: FC supports risk-adapted postoperative surveillance and may help identify patients needing ileocolonoscopy. It cannot independently replace scheduled endoscopic assessment or establish recurrence.
Keywords: Fecal calprotectin; Crohn disease; Postoperative recurrence; Biomarkers; Ileocolonoscopy; Literature review.
Información del manuscrito:
Fecha de recepción: 20 de julio de 2026.
Fecha de aceptación: 28 de septiembre de 2026.
Fecha de publicación: 30 de octubre de 2026.
Descargas
Citas
De Cruz P, Kamm MA, Hamilton AL, et al. Crohn’s disease management after intestinal resection: a randomised trial. Lancet. 2015;385(9976):1406-1417. doi:10.1016/S0140-6736(14)61908-5.
Adamina M, Minozzi S, Warusavitarne J, et al. ECCO Guidelines on Therapeutics in Crohn’s Disease: Surgical Treatment. J Crohns Colitis. 2024;18(10):1556-1582. doi:10.1093/ecco-jcc/jjae089.
Ananthakrishnan AN, Adler J, Chachu KA, et al. AGA Clinical Practice Guideline on the Role of Biomarkers for the Management of Crohn’s Disease. Gastroenterology. 2023;165(6):1367-1399. doi:10.1053/j.gastro.2023.09.029.
Wright EK, Kamm MA, De Cruz P, et al. Measurement of fecal calprotectin improves monitoring and detection of recurrence of Crohn’s disease after surgery. Gastroenterology. 2015;148(5):938-947.e1. doi:10.1053/j.gastro.2015.01.026.
Qiu Y, Mao R, Chen BL, et al. Fecal calprotectin for evaluating postoperative recurrence of Crohn’s disease: a meta-analysis of prospective studies. Inflamm Bowel Dis. 2015;21(2):315-322. doi:10.1097/MIB.0000000000000262.
Tham YS, Yung DE, Fay S, Yamamoto T, Ben-Horin S, Eliakim R, et al. Fecal calprotectin for detection of postoperative endoscopic recurrence in Crohn’s disease: systematic review and meta-analysis. Therap Adv Gastroenterol. 2018;11:1756284818785571. doi:10.1177/1756284818785571.
Samnani S, Ray CM, Gill P, et al. Diagnostic accuracy of noninvasive biomarkers and imaging for evaluating postoperative recurrence in Crohn’s disease. Clin Gastroenterol Hepatol. 2025;23(13):2433-2447.e9. doi:10.1016/j.cgh.2025.03.030.
Boschetti G, Laidet M, Moussata D, et al. Levels of fecal calprotectin are associated with the severity of postoperative endoscopic recurrence in asymptomatic patients with Crohn’s disease. Am J Gastroenterol. 2015;110(6):865-872. doi:10.1038/ajg.2015.30.
Herranz Bachiller MT, Barrio Andres J, Fernandez Salazar L, Ruiz-Zorrilla R, Sancho Del Val L, Atienza Sanchez R. The utility of faecal calprotectin to predict post-operative recurrence in Crohn’s disease. Scand J Gastroenterol. 2016;51(6):720-726. doi:10.3109/00365521.2015.1130164.
Garcia-Planella E, Mañosa M, Cabré E, et al. Fecal calprotectin levels are closely correlated with the absence of relevant mucosal lesions in postoperative Crohn’s disease. Inflamm Bowel Dis. 2016;22(12):2879-2885. doi:10.1097/MIB.0000000000000960.
Li T, Shah R, Click B, et al. American Gastroenterological Association-proposed fecal calprotectin cutoff of 50 ug/g is associated with endoscopic recurrence in a real-world cohort of patients with Crohn’s disease post-ileocolic resection. Crohns Colitis 360. 2024;6(1):otae016. doi:10.1093/crocol/otae016.
Veyre F, Boschetti G, Meunier C, et al. Low levels of fecal calprotectin 3 months after surgery predict subsequent endoscopic postoperative remission in Crohn’s disease. Dig Dis Sci. 2021;66(12):4429-4435. doi:10.1007/s10620-020-06751-z.
Boube M, Laharie D, Nancey S, et al. Variation of faecal calprotectin level within the first three months after bowel resection is predictive of endoscopic postoperative recurrence in Crohn’s disease. Dig Liver Dis. 2020;52(7):740-744. doi:10.1016/j.dld.2020.03.020.
Liu R, Guo Z, Cao L, Wang Z, Gong J, Li Y, Zhu W. Profile of consecutive fecal calprotectin levels in the perioperative period and its predictive capacity for early endoscopic recurrence in Crohn’s disease. Dis Colon Rectum. 2019;62(3):318-326. doi:10.1097/DCR.0000000000001263.
Primas C, Hopf G, Reinisch S, Baumann L, Novacek G, Reinisch W, Vogelsang H. Role of fecal calprotection in predicting endoscopic recurrence in postoperative Crohn’s disease. Scand J Gastroenterol. 2021;56(10):1169-1174. doi:10.1080/00365521.2021.1955965.
Cerrillo E, Moret I, Iborra M, et al. A nomogram combining fecal calprotectin levels and plasma cytokine profiles for individual prediction of postoperative Crohn’s disease recurrence. Inflamm Bowel Dis. 2019;25(10):1681-1691. doi:10.1093/ibd/izz053.
Mañosa M, Oller B, Garcia-Planella E, et al. Faecal calprotectin-based strategy for long-term monitoring of patients with Crohn’s disease without or with mild endoscopic postoperative recurrence. Dig Liver Dis. 2025;57(3):697-701. doi:10.1016/j.dld.2024.11.028.
Gutiérrez-Rios L, Calafat M, Vayreda E, Mañosa M, Domènech E. Faecal calprotectin to monitor response to treatment escalation for endoscopic postoperative recurrence of Crohn’s disease. Gastroenterol Hepatol. 2026;49(6):502654. doi:10.1016/j.gastrohep.2026.502654.
Imbrizi M, Baima JP, Azevedo MFC, et al. Second Brazilian consensus on the management of Crohn’s disease in adults: a consensus of the Brazilian Organization for Crohn’s Disease and Colitis (GEDIIB). Arq Gastroenterol. 2022;59(Suppl 1):20-50. doi:10.1590/S0004-2803.2022005S1-02.
Juliao-Baños F, Grillo CF, Pineda LF, et al. Guía de práctica clínica para el tratamiento de la enfermedad de Crohn en población adulta. Rev Colomb Gastroenterol. 2020;35(Supl 2):63-200. doi:10.22516/25007440.637.
Juliao-Baños F, Parra-Izquierdo V, Abreu G, et al. Guía informada por la evidencia para el manejo de la enfermedad de Crohn en población adulta: recomendaciones de la Pan American Crohn’s and Colitis Organisation (PANCCO). Rev Gastroenterol Peru. 2026;46(3):351-372. doi:10.47892/rgp.2026.463.2299.
Rivière P, Pekow J, Hammoudi N, et al. Comparison of the risk of Crohn’s disease postoperative recurrence between modified Rutgeerts score i2a and i2b categories: an individual patient data meta-analysis. J Crohns Colitis. 2023;17(2):269-276. doi:10.1093/ecco-jcc/jjac137.
Parra-Izquierdo V, Frías Ordoñez JS, Eggermont E, Verstockt B. Intestinal ultrasound for the detection of postoperative recurrence in Crohn’s disease: a systematic review and meta-analysis. J Crohns Colitis. 2026;20(7):jjag094. doi:10.1093/ecco-jcc/jjag094.
Ma C, Albashir S, Allocca M, et al. Intestinal ultrasound to detect postoperative recurrence in patients with Crohn’s disease: an international, multidisciplinary, RAND/UCLA appropriateness method study. Lancet Gastroenterol Hepatol. 2026;11(7):602-615. doi:10.1016/S2468-1253(26)00082-8.
Hukkinen M, Pakarinen MP, Merras-Salmio L, Koivusalo A, Rintala R, Kolho KL. Fecal calprotectin in the prediction of postoperative recurrence of Crohn’s disease in children and adolescents. J Pediatr Surg. 2016;51(9):1467-1472. doi:10.1016/j.jpedsurg.2016.01.017.
Fanizzi F, D’Amico F, Zilli A, et al. Emerging role of intestinal ultrasound in detecting postoperative recurrence in Crohn’s disease. Gastroenterol Rep (Oxf). 2026;14:goag064. doi:10.1093/gastro/goag064.
Publicado
Cómo citar
Licencia
Derechos de autor 2026 REVISTA CIENTÍFICA MULTIDISCIPLINARIA ARBITRADA YACHASUN - ISSN: 2697-3456
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
