Fecal lactoferrin as a diagnostic biomarker effectively distinguished between inflammatory bowel disease and irritable bowel syndrome in a recent study.
Seeking a less invasive and more economical alternative to standard endoscopy and radiographic imaging for discounting inflammatory bowel disease (IBD) in patients with symptoms of irritable bowel syndrome (IBS), researchers in China assessed the diagnostic utility of fecal lactoferrin (FL) levels in discriminating between IBD and IBS. They performed a meta-analysis of seven relevant studies sourced from Medline, Embase and other databases through November 2013.
After analyzing a cohort of 1,012 adult and pediatric patients (609 with IBD, 381 with IBS, 22 controls), sensitivities of FL in differentiating IBD from IBS ranged from 0.69 to 0.86, with a pooled sensitivity of 0.78 (95% CI, 0.75-0.82). Specificities ranged from 0.83 to 1, with a pooled specificity of 0.94 (95% CI, 0.91-0.96). Pooled positive likelihood ratio was 12.31 (95% CI, 6.05-25.07), pooled negative likelihood ratio was 0.23 (95% CI, 0.18-0.29), pooled diagnostic OR was 52.65 (95% CI, 25.69-107.91) and the pooled summary receiver-operating characteristic AUC was 0.94 (95% CI, 0.9-0.98).
“To our knowledge, this study is the first … to assess the diagnostic performance of FL in differentiating between IBD and IBS,” the researchers wrote. “This meta-analysis showed that FL appears to have good diagnostic precision in distinguishing IBD from IBS both in adults and children.
“Owing to study limitations [including a small cohort with few controls], additional high-quality original studies (especially in patients stratified by disease type, severity and distribution) are required to confirm the predictive value of FL.”
Disclosure: The researchers report no relevant financial disclosures.