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

Am J Emerg Med. 2011 Mar;29(3):256-60. doi: 10.1016/j.ajem.2009.09.029. Epub 2010 Mar 25.

Abstract

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: 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.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Appendicitis / blood
  • Appendicitis / diagnosis*
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Lactoferrin / blood*
  • Leukocyte Count
  • Leukocyte L1 Antigen Complex / blood*
  • Male
  • Middle Aged
  • Neutrophil Activation
  • Pilot Projects
  • Young Adult

Substances

  • Biomarkers
  • Leukocyte L1 Antigen Complex
  • C-Reactive Protein
  • Lactoferrin