S100A8/A9: A Potential New Diagnostic Aid for Acute Appendicitis
S100A8/A9: A Potential New Diagnostic Aid for Acute Appendicitis
复制标题
DOI：
10.1111/j.1553-2712.2010.00663.x
复制
发表时间：
2010-03-01
影响因子：
4.4
通讯作者：
Colgin, Mark
中科院分区：
文献类型：
--
作者：
Bealer, John F.;Colgin, Mark
目的：诊断急性阑尾炎是一个艰巨的临床挑战，因为没有一个单一的测试，可靠地区分急性阑尾炎从其他病因的急性腹痛。方法：收集181例急性腹痛急诊科（艾德）患者的血浆标本，采用免疫分析法检测血清S100 A8/A9。结果：血清S100 A8/A9对急性阑尾炎诊断的敏感性为93%（95%可信区间[CI] = 81%~ 97%），特异性为54%（95% CI = 45%~ 62%）。阴性预测值（NPV）为96%（95% CI = 89%至99%），阳性预测值（PPV）为37%（95% CI = 28%至47%）。还估计了白色血细胞（WBC）计数升高的性能特征：灵敏度63%（95% CI = 47%-76%），特异性67%（95% CI = 59%-75%），NPV 86%（95% CI = 78%-91%），PPV 36%（95% CI = 26%至47%）。这是首次报道探讨循环S100 A8/A9和急性阑尾炎，并建立了这种生物标志物作为急性阑尾炎诊断试验的概念证明。进一步的研究表明，优化使用这种生物标志物，与其他建立的方法相结合，学术急诊医学2010; 17：333-336（C）2010由社会学术急诊医学。
Objectives:Diagnosing acute appendicitis is a daunting clinical challenge, as there is no single test that reliably distinguishes acute appendicitis from other etiologies of acute abdominal pain. In this study, the authors examined whether circulating levels of S100A8/A9 could be useful as a marker to aid in the diagnosis of acute appendicitis.Methods:Plasma samples from emergency department (ED) patients with acute abdominal pain (n = 181) were tested using an immunoassay for S100A8/A9.Results:The sensitivity and specificity for S100A8/A9 in diagnosing acute appendicitis were estimated to be 93% (95% confidence interval [CI] = 81% to 97%) and 54% (95% CI = 45% to 62%), respectively. Negative predictive value (NPV) was 96% (95% CI = 89% to 99%), and positive predictive value (PPV) was 37% (95% CI = 28% to 47%). Performance characteristics of elevated white blood cell (WBC) count were also estimated: sensitivity 63% (95% CI = 47% to 76%), specificity 67% (95% CI = 59% to 75%), NPV 86% (95% CI = 78% to 91%), and PPV 36% (95% CI = 26% to 47%).Conclusions:This is the first report exploring the relationship between circulating S100A8/A9 and acute appendicitis and establishes proof of concept for this biomarker as a diagnostic test for acute appendicitis. Further studies are indicated to optimize the use of this biomarker, in conjunction with other established approaches.ACADEMIC EMERGENCY MEDICINE 2010; 17:333-336 (C) 2010 by the Society for Academic Emergency Medicine.