Fecal calprotectin level as a marker of esophageal varices in Egyptian HCV cirrhotic patients

Introduction and aim: Esophageal varices are one of the complications of portal hypertension in cirrhotic patients that lead to high morbidity and mortality. Our aim was to assess the fecal calprotectin (FC) level in Egyptian cirrhotic patients as a non-invasive marker for the presence of esophageal varices. Materials and methods: The current study included 250 participants in the period from June 2019 to November 2020, divided into 3 groups: group 1: 100 HCV cirrhotic patients with esophageal varices that would then be subdivided, according to the Paquet classification; group 2: 100 HCV cirrhotic patients without esophageal varices; group 3: 50 normal age and sex-matched healthy subjects as the control group. Patients with other causes of abnormal calprotectin results were excluded. Results: The comparison of FC in the 3 study groups revealed a statistically significant difference, with FC levels higher in groups 1 and 2 (mean 66.4 ± 10.41 and 48.4 ± 10.92, respectively). There was a significant difference in FC levels between the subgroups, subdivided according to the Paquet classification (P = .001). FC levels were higher in the grade III and IV subgroups. FC in the diagnosis of HCV cirrhotic patients with esophageal varices showed the best performance when the cut-off value was > 55; AUC was 0.918, with 92% sensitivity, 95% specificity, and 93% accuracy. Conclusion: FC levels serve as a screening tool for esophageal varices. FC was higher in cirrhotic patients with esophageal varices, especially in the grade III and IV subgroups, according to the Paquet classification.