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

作者：Thuijls Geertje; Derikx Joep P M; Prakken Fred J; Huisman Bregje; van Bijnen Annemarie A; van Heurn Ernest L W E; Buurman Wim A^*; Heineman Erik

来源：American Journal of Emergency Medicine, 2011, 29(3): 256-260.

DOI：10.1016/j.ajem.2009.09.029

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.
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: lactofen-in (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.
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.
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.

• 出版日期2011-3