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Diagnostic Value of Procalcitonin and Apo-E in Extrahepatic Biliary Atresia

机译:降钙素原和Apo-E在肝外胆道闭锁中的诊断价值

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摘要

>Objective: Extrahepatic biliary atresia (EHBA) is one of the main causes of neonatal cholestasis. Its early diagnosis could increase the survival of the infants with early surgery. We evaluated the diagnostic accuracy of procalcitonin and apolipoprotein E (Apo-E) levels in infants with and without EHBA. >Methods: This prospective study included 18 infants with EHBA and 15 infants with other causes of cholestasis. Blood samples were taken from each patient and different markers including procalcitonin and Apo-E levels were measured. ROC analysis was used to define sensitivity, specificity, positive and negative predictive value (PPV and NPV) for procalcitonin and Apo-E. >Findings >: There was a significantly positive correlation between Apo-E and SGOT (r=0.37, P=0.03), SGPT (r=0.38, P=0.02) and GGT (r=0.38, P=0.02), and an inverse correlation between procalcitonin and GGT (r=-0.45, P=0.01). Area under curve (AUC) for procalcitonin was 0.69 (P=0.05) with cut-point of 0.735 ng/ml. The sensitivity, specificity, PPV and NPV was 67%, 61%, 69% and 59%, respectively. AUC for Apo-E was 0.68 (P=0.06) for cut-point of 61.25 ng/ml with sensitivity, specificity, PPV and NPV of 67%, 67%, 71% and 67%, respectively. >Conclusion: Both PCT and Apo-E have relatively good accuracy in diagnosing EHBA cases; we could not rely on these markers for diagnosis of EHBA, however, combinations of these biomarkers with other markers and imaging tests could improve their accuracy and may help to achieve a rapid and accurate diagnosis of EHBA.
机译:>目的:肝外胆道闭锁(EHBA)是新生儿胆汁淤积的主要原因之一。它的早期诊断可以提高早期手术婴儿的生存率。我们评估了有和没有EHBA的婴儿中降钙素原和载脂蛋白E(Apo-E)水平的诊断准确性。 >方法:这项前瞻性研究包括18例EHBA婴儿和15例其他引起胆汁淤积的婴儿。从每位患者中采集血样,并测量包括降钙素和Apo-E水平在内的不同标志物。 ROC分析用于定义降钙素和Apo-E的敏感性,特异性,阳性和阴性预测值(PPV和NPV)。 >发现 >: Apo-E与SGOT(r = 0.37,P = 0.03),SGPT(r = 0.38,P = 0.02)和GGT之间存在显着正相关。 (r = 0.38,P = 0.02),降钙素原与GGT呈负相关(r = -0.45,P = 0.01)。降钙素原的曲线下面积(AUC)为0.69(P = 0.05),切点为0.735 ng / ml。敏感性,特异性,PPV和NPV分别为67%,61%,69%和59%。切点为61.25 ng / ml,Apo-E的AUC为0.68(P = 0.06),敏感性,特异性,PPV和NPV分别为67%,67%,71%和67%。 >结论:PCT和Apo-E在诊断EHBA病例中均具有相对较高的准确性;我们不能依靠这些标志物来诊断EHBA,但是,将这些生物标志物与其他标志物和影像学检查结合使用可以提高其准确性,并有助于实现EHBA的快速准确诊断。

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