Serum and Urine Biomarker Leucine-Rich Alpha-2 Glycoprotein 1 Differentiates Pediatric Acute Complicated and Uncomplicated Appendicitis.

Autor: Kakar M; Department of Pediatric Surgery, Children's Clinical University Hospital, LV-1004 Riga, Latvia.; Department of Pediatric Surgery, Riga Stradins University, LV-1007 Riga, Latvia., Berezovska MM; Department of Pediatric Surgery, Children's Clinical University Hospital, LV-1004 Riga, Latvia.; Department of Pediatric Surgery, Riga Stradins University, LV-1007 Riga, Latvia., Broks R; Department of Biology and Microbiology, Riga Stradins University, LV-1007 Riga, Latvia., Asare L; Statistical Unit, Riga Stradins University, LV-1007 Riga, Latvia., Delorme M; Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia., Crouzen E; Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia., Zviedre A; Department of Pediatric Surgery, Children's Clinical University Hospital, LV-1004 Riga, Latvia.; Department of Pediatric Surgery, Riga Stradins University, LV-1007 Riga, Latvia., Reinis A; Department of Biology and Microbiology, Riga Stradins University, LV-1007 Riga, Latvia., Engelis A; Department of Pediatric Surgery, Children's Clinical University Hospital, LV-1004 Riga, Latvia.; Department of Pediatric Surgery, Riga Stradins University, LV-1007 Riga, Latvia., Kroica J; Department of Biology and Microbiology, Riga Stradins University, LV-1007 Riga, Latvia., Saxena A; Department of Pediatric Surgery, Chelsea Children's Hospital, Chelsea and Westminster NHS Fdn Trust, Imperial College London, London SW10 9NH, UK., Petersons A; Department of Pediatric Surgery, Children's Clinical University Hospital, LV-1004 Riga, Latvia.; Department of Pediatric Surgery, Riga Stradins University, LV-1007 Riga, Latvia.
Jazyk: angličtina
Zdroj: Diagnostics (Basel, Switzerland) [Diagnostics (Basel)] 2021 May 11; Vol. 11 (5). Date of Electronic Publication: 2021 May 11.
DOI: 10.3390/diagnostics11050860
Abstrakt: Purpose: This prospective, single-center cohort study analyzes the potential of inflammatory protein mediator leucine-rich alpha-2 glycoprotein 1 (LRG1) for the early and accurate diagnosis of acute appendicitis (AA), and differentiation of acute complicated (AcA) from uncomplicated appendicitis (AuA).
Methods: Participants were divided into the AcA, AuA, and control groups, and their serum (s-LRG1) and urine LRG1 (u-LRG1) levels were assayed preoperatively on the second and fifth postoperative days.
Results: 153 patients participated, 97 had AA. Preoperative u-LRG1 with a cut-off value of 0.18 μg/mL generated an area under the receiver operated characteristic (AUC) curve of 0.70 (95% CI 0.62-0.79) for AA versus control ( p < 0.001), while the results for AcA versus AuA were not significant (AUC 0.60, 95% CI 0.49-0.71, p = 0.089). The s-LRG1 levels of AA versus the control with a cut-off value of 51.69 μg/mL generated an AUC of 0.94 (95% CI 0.91-0.99, p < 0.001). The cut-off value of s-LRG1 was 84.06 μg/mL for diagnosis of AcA from AuA, and therefore, significant (AUC 0.69, 95% CI 0.59-0.80, p = 0.001).
Conclusions: LRG1 exhibited excellent diagnostic performance as an inexpensive, non-invasive, rapid, and accurate biomarker able to reflect the pathogenesis of AA. LRG1 has the potential to replace advanced imaging to diagnose clinically ambiguous AA cases.
Databáze: MEDLINE
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