Ulus Travma Acil Cerrahi Derg. 2020; 26(2): 191-196 | DOI: 10.14744/tjtes.2019.26270

Akut apandisit tanýsýnda GCP-2/CXCL-6 ve hs-CRP’nin tanýsal deðeri

Çiðdem Yücel¹, Esra Fýrat Oðuz², Sadettin Er³, Ýlhan Balamir⁴, Turan Turhan², Mesut Tez^3
1Gülhane Eðitim ve Araþtýrma Hastanesi, Týbbi Biyokimya Kliniði, Ankara
²Ankara Numune Eðitim ve Araþtýrma Hastanesi, Týbbi Biyokimya Kliniði, Ankara
³Ankara Numune Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Ankara
⁴Ankara Atatürk Göðüs Hastalýklarý ve Göðüs Cerrahisi Eðitim ve Araþtýrma Hastanesi, Klinik Biyokimya Kliniði, Ankara

AMAÇ: Akut apandisit (AA), akut karýn aðrýsýnýn en önemli nedenlerinden biridir. AA tanýsý için çeþitli laboratuvar belirteçleri çalýþýlmýþtýr, ancak hiçbiri fizik muayene veya görüntülemeye üstünlük göstermemiþtir. GCP-2/CXCL6, enflamasyon sýrasýnda makrofajlar ve epitelyal ve mezenkimal hücreler tarafýndan eksprese edilen bir kemokindir. Bu çalýþmanýn amacý AA hastalarýnda GCP-2/CXCL6’nýn tanýsal rolünü araþtýrmaktýr.
GEREÇ VE YÖNTEM: Bu kesitsel çalýþmada, serum GCP-2/CXCL6 düzeyi 56 AA hastasý ve 32 saðlýklý kontrolde ölçülmüþtür. Ayrýca, hasta ve kontrol gruplarýnýn hs-CRP ve lökosit (WBC) düzeyleri deðerlendirilmiþtir.
BULGULAR: Akut apandisit grubunun GCP-2/CXCL-6, hs-CRP ve WBC düzeyleri kontrol grubundan anlamlý derecede yüksekti (tüm karþýlaþtýrmalar için p<0.05). AA grubu arasýnda ise, GCP-2/CXCL6 seviyeleri kompleks AA’da (gangrenöz, apse ve perforasyon), kompleks olmayan AA’lara göre daha yüksekti (p<0.05). GCP-2/CXCL6 seviyeleri ile hsCRP seviyeleri arasýnda güçlü bir pozitif korelasyon bulunmuþtur (r=0.756, p=0.003) ve GCP-2/CXCL6 seviyeleri ile WBC sayýsý arasýnda orta derecede pozitif korelasyon bulunmuþtur (r=0.468, p=0.003). TARTIÞMA: GCP-2/CXCL6, AA teþhisinde ve karmaþýk olgularýn ayýrt edilmesinde, özellikle diðer laboratuvar belirteçleri ve görüntüleme teknikleriyle birleþtirildiðinde yararlý bir belirteç olabilir.

Anahtar Kelimeler: Akut apandisit, kemokin; komplikasyon; prognoz; taný.

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Diagnostic value of GCP-2/CXCL-6 and hs-CRP in the diagnosis of acute appendicitis

Çiðdem Yücel¹, Esra Fýrat Oðuz², Sadettin Er³, Ýlhan Balamir⁴, Turan Turhan², Mesut Tez^3
1Department of Clinical Biochemistry, Gülhane Training and Research Hospital, Ankara-Turkey
²Department of Clinical Biochemistry, Ankara Numune Training and Research Hospital, Ankara-Turkey
³Department of General Surgery, Ankara Numune Training and Research Hospital, Ankara-Turkey
⁴Department of Clinical Biochemistry, Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara-Turkey

BACKGROUND: Acute appendicitis (AA) is one of the major causes of acute abdomen pain. Various laboratory markers have been studied for diagnosis of AA, but none of them have shown superiority to physical examination or imaging. GCP-2/CXCL6 is a chemokine expressed by macrophages and epithelial and mesenchymal cells during inflammation. The present study aims to investigate the diagnostic role of GCP-2/CXCL6 in AA patients.
METHODS: In this cross-sectional study, the serum level of GCP-2/CXCL6 was measured in 56 AA patients and 32 healthy control subjects. Also, hs-CRP and white blood cell count (WBC) levels of the patient and control groups were evaluated.
RESULTS: GCP-2/CXCL-6, hs-CRP and WBC levels of the AA group were significantly higher than the control group (p<0.05 for all comparisons). Among AA group, GCP-2/CXCL6 levels were higher in complex AA (gangrenous, abscess and perforation) ones when compared to non-complex AA (p<0.05). A strong positive correlation was found between GCP-2/CXCL6 levels and hs-CRP levels (r=0.756, p=0.003) and a moderate positive correlation between GCP-2/CXCL6 levels and WBC count (r=0.468, p=0.003).
CONCLUSION: GCP-2/CXCL6 can be a useful marker in AA diagnosis and discrimination of complex cases, especially if combined with other laboratory markers and imaging techniques.

Keywords: Acute appendicitis, chemokine, complication; diagnosis; prognosis.

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