{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T16:02:08Z","timestamp":1766073728167,"version":"3.48.0"},"reference-count":33,"publisher":"Walter de Gruyter GmbH","issue":"1","funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["111-2314-B-002-188-MY3"],"award-info":[{"award-number":["111-2314-B-002-188-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Liver Disease Prevention and Treatment Research Foundation, Taiwan"},{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["NTUH MS-507"],"award-info":[{"award-number":["NTUH MS-507"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2025-0747_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Our previous study revealed a correlation between fecal leukocyte esterase and fecal calprotectin levels. This study assessed the predictive value of fecal leukocyte esterase compared with fecal calprotectin and C-reactive protein of inflammatory bowel disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0747_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with inflammatory bowel disease who underwent ileocolonoscopy at National Taiwan University Hospital from March 2022 to March 2024 were included. Fecal leukocyte esterase and fecal calprotectin levels from stool samples collected within one month of endoscopy were analyzed. Active ulcerative colitis and Crohn\u2019s disease were defined as Mayo endoscopic score\u00a0\u22652 or simple endoscopic score for Crohn\u2019s disease\u00a0\u22657, respectively. Sensitivity, specificity, predictive values, and areas under the receiver operating characteristic curve were calculated using IBM SPSS Statistics\u00a029.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0747_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 203 patients (100 with ulcerative colitis and 103 with Crohn\u2019s disease), fecal leukocyte esterase levels were significantly correlated with fecal calprotectin levels (r=0.425, p&lt;0.001) and endoscopic severity in ulcerative colitis (r=0.432, p&lt;0.001) and Crohn\u2019s disease (r=0.311, p=0.001). For predicting Mayo endoscopic scores\u00a0\u22652 in ulcerative colitis using fecal leukocyte esterase, fecal calprotectin, and C-reactive protein, areas under the curve were 0.731, 0.785, and 0.558, respectively. For predicting simple endoscopic scores for Crohn\u2019s disease\u00a0\u22657, areas under the curve were 0.706, 0.800, and 0.770, respectively. No significant difference was observed between fecal leukocyte esterase and fecal calprotectin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0747_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fecal leukocyte esterase correlates with fecal calprotectin and predicts endoscopic severity in inflammatory bowel disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2025-0747","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T03:58:46Z","timestamp":1756526326000},"page":"176-184","source":"Crossref","is-referenced-by-count":0,"title":["Fecal leukocyte esterase levels predict endoscopic severity as an alternative biomarker in inflammatory bowel disease"],"prefix":"10.1515","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2576-4360","authenticated-orcid":false,"given":"Feng-Pai","family":"Tsai","sequence":"first","affiliation":[{"name":"Department of Internal Medicine , National Taiwan University Hospital , Taipei , Taiwan"},{"name":"Department of Medicine , National Taiwan University Cancer Center , Taipei , Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4143-6607","authenticated-orcid":false,"given":"Meng-Tzu","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , National Taiwan University Hospital , Taipei , Taiwan"},{"name":"Department of Medical Research , National Taiwan University Hospital Hsin-Chu Branch , Hsinchu County , Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3084-5579","authenticated-orcid":false,"given":"Hsin-Yun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , National Taiwan University Hospital , Taipei , Taiwan"},{"name":"Department of Internal Medicine , National Taiwan University Hospital Jin-Shan Branch , New Taipei City , Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3186-3056","authenticated-orcid":false,"given":"Zhi-Che","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , National Taiwan University Hospital , Taipei , Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-9064","authenticated-orcid":false,"given":"Chien-Chih","family":"Tung","sequence":"additional","affiliation":[{"name":"Department of Integrated Diagnostics and Therapeutics , National Taiwan University Hospital , Taipei , Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8007-2590","authenticated-orcid":false,"given":"Chun-Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Research , National Taiwan University Hospital Hsin-Chu Branch , Hsinchu County , Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5017-5840","authenticated-orcid":false,"given":"Shu-Chen","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine , National Taiwan University Hospital , Taipei , Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"2025121815555033653_j_cclm-2025-0747_ref_001","doi-asserted-by":"crossref","unstructured":"Hazel, K, O\u2019Connor, A. Emerging treatments for inflammatory bowel disease. Therapeut Adv Chron Dis 2020;11:2040622319899297. https:\/\/doi.org\/10.1177\/2040622319899297.","DOI":"10.1177\/2040622319899297"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_002","doi-asserted-by":"crossref","unstructured":"Neurath, MF, Travis, SP. Mucosal healing in inflammatory bowel diseases: a systematic review. Gut 2012;61:1619\u201335. https:\/\/doi.org\/10.1136\/gutjnl-2012-302830.","DOI":"10.1136\/gutjnl-2012-302830"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_003","doi-asserted-by":"crossref","unstructured":"Turner, D, Ricciuto, A, Lewis, A, D\u2019Amico, F, Dhaliwal, J, Griffiths, AM, et al.. STRIDE-II: an update on the selecting therapeutic targets in inflammatory bowel disease (STRIDE) initiative of the international organization for the study of IBD (IOIBD): determining therapeutic goals for treat-to-target strategies in IBD. Gastroenterology 2021;160:1570\u201383. https:\/\/doi.org\/10.1053\/j.gastro.2020.12.031.","DOI":"10.1053\/j.gastro.2020.12.031"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_004","doi-asserted-by":"crossref","unstructured":"Gracie, DJ, Williams, CJ, Sood, R, Mumtaz, S, Bholah, MH, Hamlin, PJ, et al.. Poor correlation between clinical disease activity and mucosal inflammation, and the role of psychological comorbidity, in inflammatory bowel disease. Am J Gastroenterol 2016;111:541\u201351. https:\/\/doi.org\/10.1038\/ajg.2016.59.","DOI":"10.1038\/ajg.2016.59"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_005","doi-asserted-by":"crossref","unstructured":"Wei, SC, Tung, CC, Weng, MT, Wong, JM. Experience of patients with inflammatory bowel disease in using a home fecal calprotectin test as an objective reported outcome for self-monitoring. Intestinal Res 2018;16:546\u201353. https:\/\/doi.org\/10.5217\/ir.2018.00052.","DOI":"10.5217\/ir.2018.00052"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_006","doi-asserted-by":"crossref","unstructured":"Mosli, MH, Zou, G, Garg, SK, Feagan, SG, MacDonald, JK, Chande, N, et al.. C-Reactive protein, fecal calprotectin, and stool lactoferrin for detection of endoscopic activity in symptomatic inflammatory bowel disease patients: a systematic review and meta-analysis. Am J Gastroenterol 2015;110:802\u201319; quiz 20. https:\/\/doi.org\/10.1038\/ajg.2015.120.","DOI":"10.1038\/ajg.2015.120"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_007","doi-asserted-by":"crossref","unstructured":"Wright, EK, Kamm, MA, De Cruz, P, Hamilton, AL, Ritchie, KJ, Krejany, EO, et al.. Measurement of fecal calprotectin improves monitoring and detection of recurrence of Crohn\u2019s disease after surgery. Gastroenterology 2015;148:938\u201347 e1. https:\/\/doi.org\/10.1053\/j.gastro.2015.01.026.","DOI":"10.1053\/j.gastro.2015.03.017"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_008","doi-asserted-by":"crossref","unstructured":"Plevris, N, Fulforth, J, Lyons, M, Siakavellas, SI, Jenkinson, PW, Chuah, CS, et al.. Normalization of fecal calprotectin within 12\u00a0months of diagnosis is associated with reduced risk of disease progression in patients with Crohn\u2019s disease. Clin Gastroenterol Hepatol: Off Clin Pract J Am Gastroenterol Assoc 2021;19:1835\u201344.e6. https:\/\/doi.org\/10.1016\/j.cgh.2020.08.022.","DOI":"10.1016\/j.cgh.2020.08.022"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_009","doi-asserted-by":"crossref","unstructured":"Sollelis, E, Quinard, RM, Bouguen, G, Goutte, M, Goutorbe, F, Bouvier, D, et al.. Combined evaluation of biomarkers as predictor of maintained remission in Crohn\u2019s disease. World J Gastroenterol 2019;25:2354\u201364. https:\/\/doi.org\/10.3748\/wjg.v25.i19.2354.","DOI":"10.3748\/wjg.v25.i19.2354"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_010","doi-asserted-by":"crossref","unstructured":"Guidi, L, Marzo, M, Andrisani, G, Felice, C, Pugliese, D, Mocci, G, et al.. Faecal calprotectin assay after induction with anti-Tumour necrosis factor \u03b1 agents in inflammatory bowel disease: prediction of clinical response and mucosal healing at one year. Dig Liver Dis: Off J Ital Soc Gastroenterol Ital Assoc Stud Liver 2014;46:974\u20139. https:\/\/doi.org\/10.1016\/j.dld.2014.07.013.","DOI":"10.1016\/j.dld.2014.07.013"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_011","doi-asserted-by":"crossref","unstructured":"Tsai, FP, Weng, MT, Chang, CH, Zeng, MH, Wei, SC. A simplified fecal leukocyte esterase strip test results as a low cost, widely available, alternative bowel inflammation biomarker. J\u00a0Formos Med Assoc=Taiwan yi zhi 2024;123:1099\u2013103. https:\/\/doi.org\/10.1016\/j.jfma.2024.01.025.","DOI":"10.1016\/j.jfma.2024.01.025"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_012","doi-asserted-by":"crossref","unstructured":"Khakoo, NS, Lewis, A, Roldan, GA, Al Khoury, A, Quintero, MA, Deshpande, AR, et al.. Patient adherence to fecal calprotectin testing is low compared to other commonly ordered tests in patients with inflammatory bowel disease. Crohn\u2019s colitis 360 2021;3:otab028. https:\/\/doi.org\/10.1093\/crocol\/otab028.","DOI":"10.1093\/crocol\/otab028"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_013","doi-asserted-by":"crossref","unstructured":"Kalla, R, Boyapati, R, Vatn, S, Hijos, G, Crooks, B, Moore, GT, et al.. Patients\u2019 perceptions of faecal calprotectin testing in inflammatory bowel disease: results from a prospective multicentre patient-based survey. Scand J Gastroenterol 2018;53:1437\u201342. https:\/\/doi.org\/10.1080\/00365521.2018.1527394.","DOI":"10.1080\/00365521.2018.1527394"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_014","unstructured":"European Confederation of Laboratory M. European urinalysis guidelines. Scand J Clin Lab Invest Suppl 2000;231:1\u201386."},{"key":"2025121815555033653_j_cclm-2025-0747_ref_015","doi-asserted-by":"crossref","unstructured":"Dumoulin, EN, Van Biervliet, S, De Vos, M, Himpe, J, Speeckaert, MM, Delanghe, JR, et al.. Faecal leukocyte esterase activity is an alternative biomarker in inflammatory bowel disease. Clin Chem Lab Med 2015;53:2003\u20138. https:\/\/doi.org\/10.1515\/cclm-2015-0040.","DOI":"10.1515\/cclm-2015-0040"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_016","doi-asserted-by":"crossref","unstructured":"Trasolini, R, Zhu, K, Klemm, N, Park, S, Salh, B. Fecal leukocyte esterase, an alternative biomarker to fecal calprotectin in inflammatory bowel disease: a pilot series. Gastro Hep Adv 2022;1:45\u201351. https:\/\/doi.org\/10.1016\/j.gastha.2021.10.006.","DOI":"10.1016\/j.gastha.2021.10.006"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_017","unstructured":"Phadia\u2122 250\u00a0\u2013\u00a0product information sheet. https:\/\/www.thermofisher.com\/content\/dam\/diagnostics\/commercial\/phadia\/TF_Phadia-250-ProductInformationSheet_Review.pdf."},{"key":"2025121815555033653_j_cclm-2025-0747_ref_018","doi-asserted-by":"crossref","unstructured":"Abebayehu, A. Urine test strip analysis, concentration range and its interpretations of the parameters. GSC Biol Pharm Sci 2023;22:1\u201313.","DOI":"10.30574\/gscbps.2023.22.2.0091"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_019","doi-asserted-by":"crossref","unstructured":"Schroeder, KW, Tremaine, WJ, Ilstrup, DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis. A randomized study. N\u00a0Engl J Med 1987;317:1625\u20139. https:\/\/doi.org\/10.1056\/nejm198712243172603.","DOI":"10.1056\/NEJM198712243172603"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_020","doi-asserted-by":"crossref","unstructured":"Daperno, M, D\u2019Haens, G, Van Assche, G, Baert, F, Bulois, P, Maunoury, V, et al.. Development and validation of a new, simplified endoscopic activity score for Crohn\u2019s disease: the SES-CD. Gastrointest Endosc 2004;60:505\u201312. https:\/\/doi.org\/10.1016\/s0016-5107(04)01878-4.","DOI":"10.1016\/S0016-5107(04)01878-4"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_021","doi-asserted-by":"crossref","unstructured":"Oord, T, Hornung, N. Fecal calprotectin in healthy children. Scand J Clin Lab Investig 2014;74:254\u20138. https:\/\/doi.org\/10.3109\/00365513.2013.879732.","DOI":"10.3109\/00365513.2013.879732"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_022","doi-asserted-by":"crossref","unstructured":"Silverberg, MS, Satsangi, J, Ahmad, T, Arnott, ID, Bernstein, CN, Brant, SR, et al.. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a working party of the 2005 Montreal world congress of gastroenterology. Can J Gastroenterol=J canadien de gastroenterologie 2005;19:5a\u201336a. https:\/\/doi.org\/10.1155\/2005\/269076.","DOI":"10.1155\/2005\/269076"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_023","doi-asserted-by":"crossref","unstructured":"V\u00e1zquez Mor\u00f3n, JM, Pallar\u00e9s Manrique, H, Machancoses, FH, Ramos, LM, Ruiz Frutos, C. Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohn\u2019s disease with fecal calprotectin. Rev Esp Enferm Dig 2017;109:130\u20136. https:\/\/doi.org\/10.17235\/reed.2017.4542\/2016.","DOI":"10.17235\/reed.2017.4542\/2016"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_024","doi-asserted-by":"crossref","unstructured":"Bodelier, AG, Jonkers, D, van den Heuvel, T, de Boer, E, Hameeteman, W, Masclee, AA, et al.. High percentage of IBD patients with indefinite fecal calprotectin levels: additional value of a combination score. Dig Dis Sci 2017;62:465\u201372. https:\/\/doi.org\/10.1007\/s10620-016-4397-6.","DOI":"10.1007\/s10620-016-4397-6"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_025","doi-asserted-by":"crossref","unstructured":"Morris, MW, Stewart, SA, Heisler, C, Sandborn, WJ, Loftus, EV, Zello, GA, et al.. Biomarker-based models outperform patient-reported scores in predicting endoscopic inflammatory disease activity. Inflamm Bowel Dis 2018;24:277\u201385. https:\/\/doi.org\/10.1093\/ibd\/izx018.","DOI":"10.1093\/ibd\/izx018"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_026","doi-asserted-by":"crossref","unstructured":"Ungaro, RC, Yzet, C, Bossuyt, P, Baert, FJ, Vanasek, T, D\u2019Haens, GR, et al.. Deep remission at 1\u00a0year prevents progression of early Crohn\u2019s disease. Gastroenterology 2020;159:139\u201347. https:\/\/doi.org\/10.1053\/j.gastro.2020.03.039.","DOI":"10.1053\/j.gastro.2020.03.039"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_027","doi-asserted-by":"crossref","unstructured":"Gecse, KB, Brandse, JF, van Wilpe, S, L\u00f6wenberg, M, Ponsioen, C, van den Brink, G, et al.. Impact of disease location on fecal calprotectin levels in Crohn\u2019s disease. Scand J Gastroenterol 2015;50:841\u20137. https:\/\/doi.org\/10.3109\/00365521.2015.1008035.","DOI":"10.3109\/00365521.2015.1008035"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_028","doi-asserted-by":"crossref","unstructured":"Dumoulin, EN, Van Biervliet, S, Langlois, MR, Delanghe, JR. Proteolysis is a confounding factor in the interpretation of faecal calprotectin. Clin Chem Lab Med 2015;53:65\u201371. https:\/\/doi.org\/10.1515\/cclm-2014-0568.","DOI":"10.1515\/cclm-2014-0568"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_029","doi-asserted-by":"crossref","unstructured":"Patel, HP. The abnormal urinalysis. Pediatr Clin 2006;53:325\u201337. https:\/\/doi.org\/10.1016\/j.pcl.2006.02.004.","DOI":"10.1016\/j.pcl.2006.02.004"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_030","doi-asserted-by":"crossref","unstructured":"Bac\u00e2rea, A, Fekete, GL, Grigorescu, BL, Bac\u00e2rea, VC. Discrepancy in results between dipstick urinalysis and urine sediment microscopy. Exp Ther Med 2021;21:538. https:\/\/doi.org\/10.3892\/etm.2021.9971.","DOI":"10.3892\/etm.2021.9971"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_031","unstructured":"Winkens, RA, Leffers, P, Degenaar, CP. Urine test strips: how reproducible are readings? Can Fam Physician Medecin de famille canadien 1992;38:1095\u20139."},{"key":"2025121815555033653_j_cclm-2025-0747_ref_032","doi-asserted-by":"crossref","unstructured":"Tibble, JA, Sigthorsson, G, Foster, R, Scott, D, Fagerhol, MK, Roseth, A, et al.. High prevalence of NSAID enteropathy as shown by a simple faecal test. Gut 1999;45:362\u20136. https:\/\/doi.org\/10.1136\/gut.45.3.362.","DOI":"10.1136\/gut.45.3.362"},{"key":"2025121815555033653_j_cclm-2025-0747_ref_033","doi-asserted-by":"crossref","unstructured":"Kim, ES. Optimal cutoff level of fecal calprotectin for detecting small bowel inflammation in Crohn\u2019s disease. Gut and liver 2021;15:637\u20138. https:\/\/doi.org\/10.5009\/gnl210393.","DOI":"10.5009\/gnl210393"}],"container-title":["Clinical Chemistry and Laboratory Medicine (CCLM)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/cclm-2025-0747\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/cclm-2025-0747\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T15:57:09Z","timestamp":1766073429000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/cclm-2025-0747\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,6,23]]},"published-print":{"date-parts":[[2026,1,27]]}},"alternative-id":["10.1515\/cclm-2025-0747"],"URL":"https:\/\/doi.org\/10.1515\/cclm-2025-0747","relation":{},"ISSN":["1434-6621","1437-4331"],"issn-type":[{"type":"print","value":"1434-6621"},{"type":"electronic","value":"1437-4331"}],"subject":[],"published":{"date-parts":[[2025,9,1]]}}}