https://doi.org/10.1140/epjs/s11734-026-02214-0
Regular Article
Analysis Fecal calprotectin and immunochemical fecal occult blood test as dual biomarkers in colorectal cancer patients in relation to the radiological diagnosis and radiotherapy: Azerbaijan experience
1
Biochemistry Department, Azerbaijan Medical University, Baku, Azerbaijan
2
Department of Radiology, Azerbaijan Medical University, Baku, Azerbaijan
3
Department of Orthopedic Dentistry, Azerbaijan Medical University, Baku, Azerbaijan
4
Pharmacognosy Department, Azerbaijan Medical University, Baku, Azerbaijan
5
Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
a
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Received:
17
August
2025
Accepted:
14
February
2026
Published online:
27
February
2026
Abstract
Colorectal neoplasia results from a multistep process involving genetic mutations, chronic inflammation, and disruption of mucosal homeostasis. Calprotectin, a calcium- and zinc-binding heterodimer of S100A8/S100A9 proteins secreted by activated neutrophils, plays an active role in innate immunity and is implicated in oncogenic signaling pathways. This study evaluates the diagnostic performance of fecal calprotectin (FC) and immunochemical fecal occult blood test (iFOBT) in 105 cancer patients and 35 controls in terms of radiology and therapy exploring FC's potential as a molecular biomarker. FC levels were quantified using ELISA assay, while iFOBT was conducted using an immunochromatographic assay. Correlation between FC levels and histological parameters (neutrophilic infiltration, mucosal ulceration) was assessed. Diagnostic accuracy was evaluated through receiver operating characteristic (ROC) curve analysis. FC's levels were significantly elevated in neoplastic lesions compared to controls (p < 0.001), with median concentrations of 180.4 µg/g in colorectal cancer and 115.2 µg/g in advanced adenomas. FC levels correlated positively with neutrophil infiltration scores (r = 0.54, p < 0.001) and histological ulceration. ROC analysis showed that FC alone yielded an AUC of 0.82, while the combination with iFOBT improved diagnostic sensitivity to 91.4% (AUC = 0.88). This study indicated that FC and iFOBT can enhance diagnostic performance and may serve as an additional parameter in clinical screening tools.
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© The Author(s), under exclusive licence to EDP Sciences, Springer-Verlag GmbH Germany, part of Springer Nature 2026
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
