A pilot study on potential new plasma markers for diagnosis of acute appendicitis

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• 作者：Geertje Thuijls MD¹ ; ^a ; Joep P.M. Derikx MD¹ ; ^a ; Fred J. Prakken MD² ; ^a ; Bregje Huisman MD^a ; Annemarie A. van Bijnen Ing^a ; Ernest L.W.E. van Heurn MD ; PhD^a ; Wim A. Buurman PhD ; ^a ; ^{w.buurman@AH.unimaas.nl} ; Erik Heineman MD ; PhD³ ; ^a
• 刊名：The American Journal of Emergency Medicine
• 出版年：2011
• 出版时间：March 2011
• 年：2011
• 卷：29
• 期：3
• 页码：256-260
• 全文大小：298 K

文摘

lass=""h4"">Background

Diagnosis of acute appendicitis (AA) remains a surgical dilemma, with negative appendectomy rates of 5 % to 40 % and perforation suggestive for late operative intervention in 5 % to 30 % . The aim of this study is to evaluate new plasma markers, representing early neutrophil activation, to improve diagnostic accuracy in patients suspected for AA.

lass=""h4"">Materials and Methods

Fifty-one patients who underwent surgery for AA were included (male-female = 28:23), and blood was sampled. Plasma concentrations of 2 neutrophil proteins were measured: lactoferrin (LF) and calprotectin (CP). Controls consisted of 27 healthy volunteers. C-reactive protein (CRP) and white blood cell count (WBC) concentrations were measured for routine patient care.

lass=""h4"">Results

Median plasma concentrations for LF and CP were significantly higher in 51 patients with proven AA (665 and 766 ng/mL, respectively) than in 27 healthy volunteers (198 and 239 ng/mL, respectively, P < .001).

No clinically relevant correlation exists between the plasma levels of LF and CP and the conventional laboratory tests for CRP and WBC.

lass=""h4"">Conclusions

Circulating LF and CP levels are significantly elevated in patients with appendicitis and are detectable in plasma using relatively simple and low-cost enzyme-linked immunosorbent assays. Furthermore, plasma levels of LF and CP give additional information to conventional markers WBC and CRP, making them potential new markers for AA diagnosis.