Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Am J Emerg Med. 2012 May;30(4):540-4. doi: 10.1016/j.ajem.2011.01.027. Epub 2011 Mar 29.
Acute appendicitis is the most common abdominal emergency in children and young adults. There are a lot of serotonin-containing cells in the appendix, which release serotonin into the bloodstream in response to inflammation. Consequently, serotonin is converted to 5-hydroxyindoleacetic acid (5-HIAA) and secreted into the urine. On this basis, urinary 5-HIAA could be a marker for acute appendicitis. In this study, we investigated the value of 5-HIAA levels in spot urine in the diagnosis of acute appendicitis.
The urinary 5-HIAA was measured by an enzyme-linked immunosorbent assay in the spot urine of 70 patients who presented to the emergency department with a clinical picture of acute appendicitis. Urine concentration results were correlated to final histopathologic reports, and the diagnostic value of this factor was measured.
Diagnosis of appendicitis was confirmed by histopathologic reports in 59 of 70 patients with presumptive diagnosis of appendicitis. Considering 5.25 mg/L as the cutoff point for urinary 5-HIAA, 28 patients had high urinary 5-HIAA levels, whereas 42 patients had values within reference range. The sensitivity and specificity of this test was 44% and 81%, respectively.
The measurement of urinary 5-HIAA levels is not an ideal diagnostic tool for ruling out or determination of acute appendicitis.
急性阑尾炎是儿童和青年中最常见的腹部急症。阑尾中含有大量的血清素细胞，这些细胞在炎症反应时会将血清素释放到血液中。因此，血清素会转化为 5-羟吲哚乙酸（5-HIAA）并分泌到尿液中。在此基础上，尿液中的 5-HIAA 可以作为急性阑尾炎的标志物。本研究旨在探讨尿 5-HIAA 水平在诊断急性阑尾炎中的价值。
对 70 例以急性阑尾炎临床表现就诊于急诊科的患者进行尿液 5-HIAA 的酶联免疫吸附试验检测。将尿液浓度结果与最终的组织病理学报告相关联，并测量该因素的诊断价值。
在 70 例疑似阑尾炎患者中，通过组织病理学报告确诊阑尾炎 59 例。以 5.25mg/L 作为尿 5-HIAA 的截断点，28 例患者的尿 5-HIAA 水平升高，42 例患者的尿 5-HIAA 值在参考范围内。该试验的灵敏度和特异性分别为 44%和 81%。
尿 5-HIAA 水平的测量并不是排除或确定急性阑尾炎的理想诊断工具。
