Ulus Travma Acil Cerrahi Derg. 2020; 26(1): 21-29 | DOI: 10.14744/tjtes.2019.27916

Akut apandisit tanýsýný koymak ve perforasyonu öngörmek için pentraxin-3 kullanýmý: Ýleriye yönelik karþýlaþtýrmalý metodolojik çalýþma

Vahit Onur Gul¹, Sabahattin Destek^2
1Gülhane Eðitim ve Araþtýrma Hastanesi Genel Cerrahi Kliniði, Ankara
²Bezmialem Vakýf Universitesi Týp Fakültesi Genel Cerrahi Kliniði, Ýstanbul

AMAÇ: Biz bu çalýþmada, pentraxin-3’ün akut apandisit için tanýsal performansýný ve perforasyon için prediktif performansýný, beyaz küre sayýsý, yüksek duyarlýklý C-reaktif protein ve interlökin-6 ile karþýlaþtýrmayý amaçladýk.
GEREÇ VE YÖNTEM: Ýleriye yönelik metodolojik türde olan bu çalýþmada, pentraxin-3, beyaz küre sayýsý, yüksek duyarlýklý C-reaktif protein ve interlökin-6’nýn akut apandisit için tanýsal performansý ve akut apandisitli hastalarda perforasyon için prediktif performansý karþýlaþtýrýldý. Kontrol grubunu, inguinal herni tanýsý alan ve kliniðimize elektif cerrahi için baþvuran hastalardan oluþturuldu. Tanýsal doðruluk ve prediktif gücünün karþýlaþtýrmasýnda “receiver operating characteristics’ analizi kullanýldý.
BULGULAR: Serum pentraxin-3 düzeyi >3.67 ng/mL olmasý, akut apandisit tanýsý için %95.5 sensitivite ve %100.0 spesifisiteye sahipken eðri altýndaki alan %0.993 (%95 CI 0.967–1.000) olarak bulundu. Ayrýca pentraxin-3 düzeyi >9.56 ng/mL olmasý, perfore akut apandisit prediksiyonu için %92.9 sensitivite ve %87.1 spesifisiteye sahipken, eðri altýndaki alan 0.820 (%95 CI 0.736–0.886) olarak bulundu.
TARTIÞMA: Pentraxin-3’ün akut apandisit için tanýsal performansý ve perforasyon için prediktif gücü beyaz küre sayýsý, yüksek duyarlýklý C-reaktif protein ve interlökin-6’ya göre yüksek bulunmuþtur.

Anahtar Kelimeler: Akut apandisit, beyaz küre sayýmý; interlökin-6; pentraxin-3; yüksek duyarlýklý C-reaktif protein.

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Using pentraxin-3 for diagnosing acute appendicitis and predicting perforation: A prospective comparative methodological study

Vahit Onur Gul¹, Sabahattin Destek^2
1Department of General Surgery, Gülhane Training and Research Hospital, Ankara-Turkey
²Department of General Surgery, Bezmialem Vakýf University Faculty of Medicine, Ýstanbul-Turkey

BACKGROUND: In this study, we aimed to investigate the diagnostic performance of pentraxin-3 for acute appendicitis, and the predictive performance for perforation in patients with acute appendicitis, compared with white blood cell count, high-sensitivity C-reactive protein and interleukin-6 (IL-6).
METHODS: This study was a prospective methodological study, in which we studied the accuracies of the serum levels of pentraxin-3, white blood cell count, interleukin-6 and high-sensitivity C-reactive protein in estimating acute appendicitis, and in estimating perforation in patients with acute appendicitis. We designed the control group with the patients diagnosed inguinal hernia and admitted for elective surgery. Receiver operating characteristics analysis was used to compare the diagnostic accuracies and predictive performances.
RESULTS: Receiver operating characteristics analysis revealed that the Pentraxin-3 level >3.67 ng/mL showed the sensitivity of 95.5% and specificity of 100.0% for diagnosing acute appendicitis, with an area under the curve of 0.993 (95% CI 0.967–1.000). Also, the Pentraxin-3 level >9.56 ng/mL showed the sensitivity of 92.9%, and the specificity of 87.1% for the prediction of the perforation, with an area under the curve of 0.820 (95% CI 0.736–0.886).
CONCLUSION: The diagnostic performance of Pentraxin-3 for acute appendicitis and the predictive performance for perforation were higher than white blood cell count, high-sensitivity C-reactive protein and interleukin-6.

Keywords: Acute appendicitis, high-sensitivity C-reactive protein; interleukin-6; pentraxin-3; white blood cell count.

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