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Open Access Research article

Fecal lactoferrin in discriminating inflammatory bowel disease from Irritable bowel syndrome: a diagnostic meta-analysis

Xing-lu Zhou1, Wen Xu1, Xiao-xiao Tang1, Lai-sheng Luo1, Jiang-feng Tu1, Chen-jing Zhang1, Xiang Xu2, Qin-dong Wu1 and Wen-sheng Pan1*

Author Affiliations

1 Department of Gastroenterology, Second Affiliated Hospital of Zhejiang University, School of Medicine, 88 Jiefang Road, Hangzhou, China

2 Department of Pharmacy, Second Affiliated Hospital of Zhejiang University, School of Medicine, 88 Jiefang Road, Hangzhou, China

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BMC Gastroenterology 2014, 14:121  doi:10.1186/1471-230X-14-121

Published: 7 July 2014

Abstract

Background

To perform a meta-analysis evaluating the diagnostic ability of fecal lactoferrin (FL) to distinguish inflammatory bowel disease (IBD) from irritable bowel syndrome (IBS).

Methods

The Medline, EMBASE, Web of Science, Cochrane library and CNKI databases were systematically searched for studies that used FL concentrations to distinguish between IBD and IBS. The sensitivity, specificity, and other diagnostic indexes of FL were pooled using a random-effects model.

Results

Seven studies, involving 1012 patients, were eligible for inclusion. In distinguishing IBD from IBS, FL had a pooled sensitivity of 0.78 (95% confidence interval [CI]: 0.75, 0.82), a specificity of 0.94 (95% CI: 0.91, 0.96), a positive likelihood ratio of 12.31 (95% CI: 5.93, 29.15), and a negative likelihood ratio of 0.23 (95% CI: 0.18, 0.29). The area under the summary receiver-operating characteristic curve was 0.94 (95% CI: 0.90, 0.98) and the diagnostic odds ratio was 52.65 (95% CI: 25.69, 107.91).

Conclusions

FL, as a noninvasive and simple marker, is useful in differentiating between IBD and IBS.

Keywords:
Fecal lactoferrin; Inflammatory bowel disease; Irritable bowel syndrome; Meta-analysis