Role of circulating fibrocytes in the diagnosis of acute appendicitis.

Autor: Zarog MA; Department of Surgery, University Hospital Limerick, Limerick, Ireland.; Graduate Entry Medical School, Inflammation and Immunity, University of Limerick, Limerick, Ireland., O'Leary DP; Department of Surgery, University Hospital Limerick, Limerick, Ireland., Kiernan MG; Department of Surgery, University Hospital Limerick, Limerick, Ireland.; Graduate Entry Medical School, Inflammation and Immunity, University of Limerick, Limerick, Ireland., Bolger J; Department of Surgery, University Hospital Limerick, Limerick, Ireland., Tibbitts P; Department of Surgery, University Hospital Limerick, Limerick, Ireland.; Graduate Entry Medical School, Inflammation and Immunity, University of Limerick, Limerick, Ireland., Coffey SN; Department of Surgery, University Hospital Limerick, Limerick, Ireland., Lowery A; Department of Surgery, University Hospital Limerick, Limerick, Ireland.; Graduate Entry Medical School, Inflammation and Immunity, University of Limerick, Limerick, Ireland., Byrnes GJ; Department of Surgery, University Hospital Limerick, Limerick, Ireland.; Graduate Entry Medical School, Inflammation and Immunity, University of Limerick, Limerick, Ireland., Peirce C; Department of Surgery, University Hospital Limerick, Limerick, Ireland.; Graduate Entry Medical School, Inflammation and Immunity, University of Limerick, Limerick, Ireland., Dunne CP; Graduate Entry Medical School, Inflammation and Immunity, University of Limerick, Limerick, Ireland.; Centre for Interventions in Infection, Inflammation and Immunity, University of Limerick, Limerick, Ireland., Coffey JC; Department of Surgery, University Hospital Limerick, Limerick, Ireland.; Graduate Entry Medical School, Inflammation and Immunity, University of Limerick, Limerick, Ireland.; Centre for Interventions in Infection, Inflammation and Immunity, University of Limerick, Limerick, Ireland.
Jazyk: angličtina
Zdroj: BJS open [BJS Open] 2020 Dec 02; Vol. 4 (6), pp. 1256-1265.
DOI: 10.1002/bjs5.50350
Abstrakt: Background: Improved diagnostic biomarkers are required for acute appendicitis. The circulating fibrocyte percentage (CFP) is increased in inflammatory states, but has not been studied in acute appendicitis. This study aimed to determine CFP in acute appendicitis and compare diagnostic accuracy with standard serological biomarkers.
Methods: A prospective cohort study was carried out between June 2015 and February 2016 at University Hospital Limerick. The CFP was determined by dual-staining peripheral venous samples for CD45 and collagen I using fluorescence-activated cell sorting, and correlated with histopathological diagnoses. The accuracy of CFP in determining histological acute appendicitis was characterized and compared with the white cell count, C-reactive protein concentration, neutrophil count, lymphocyte count and neutrophil : lymphocyte ratio.
Results: Of 95 adults recruited, 15 were healthy individuals and 80 had suspected appendicitis at presentation. Forty-six of these 80 patients had an appendicectomy, of whom 34 had histologically confirmed appendicitis. The CFP was statistically higher in patients with pathologically proven acute appendicitis than in healthy controls (median 6·1 (i.q.r. 1·6-11·6) versus 2·3 (0·9-3·4) per cent respectively; P = 0·008). The diagnostic accuracy of CFP, as determined using the area under the receiver operating characteristic (ROC) curve, was similar to that of standard biomarkers. In multinomial regression analysis, only raised CFP was retained as an independent prognostic determinant of acute appendicitis (odds ratio 1·57, 95 per cent c.i. 1·05 to 2·33; P = 0·027).
Conclusion: The CFP is increased in histologically confirmed acute appendicitis and is as accurate as standard serological biomarkers in terms of diagnosis.
(© 2020 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of British Journal of Surgery Society.)
Databáze: MEDLINE
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