Usefulness of fecal lactoferrin and hemoglobin in diagnosis of colorectal diseases

AIM： To evaluate prospectively usefulness of fecal lactoferrin （Lf） and fecal hemoglobin （Hb） in the diagnosis of colorectal diseases. METHODS： Fecal Lf and Hb were measured using ELISA in 872 patients before they underwent colorectal endoscopy. RESULTS： Lf was positive in 18 （50%） of 36 patients with colorectal cancer, 25 （15.9%） of 157 with colorectal polyps, 29 （46.8%） of 62 with ulcerative colitis, and 25 （62.5%） of 40 （62.5%） with Crohn＇s disease. The Hbpositive rates were 50%, 12.1%, 41.9% and 32.5%, respectively. Of the 318 patients free of abnormalities by colorectal endoscopy, Lf was positive in 29 （9.1%） and Hb was positive in 15 （4.7%）. Among patients with Crohn＇s disease, the Lf-positive rate was significantly higher than the Hb-positive rate. If either high Lf or Hb levels were considered positive, the positive rates rose to 61.1%, 51.6%, and 67.5% in the colorectal cancer group, ulcerative colitis group, and Crohn＇s disease group, respectively. If both high Lf and Hb levels were rated positive, the positive predictive values （PPV） were 21% for colorectal cancer, 33% for ulcerative colitis, and 17% for Crohn＇s disease, and PPV of high Hb level alone was 18%, 25% and 13%, respectively. CONCLUSION： Fecal Lf and Hb were found useful in the detection of colorectal diseases, and the combination of the two measurements appears to increase the sensitivity and efficacy of diagnosis.