Jangjoo A, Varasteh A R, Bahar M Mehrabi, Meibodi N Tayyebi, Aliakbarian M, Hoseininejad M, Esmaili H, Amouzeshi A
Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Acta Chir Belg. 2011 Jul-Aug;111(4):219-22.
Appendectomy is one of the most common surgical procedures all over the world. Although various laboratory tests and imaging studies are available to improve the accuracy of diagnosis, the rate of negative appendectomy is still about 15-30%. This study was designed to assess the diagnostic value of quantitative C-reactive protein (CRP) in patients suspected to acute appendicitis.
In a prospective study, blood samples of 102 patients were collected before appendectomy. CRP was measured by immunoturbidimetry and the data were compared with the final histopathologic reports. Diagnostic accuracy of the CRP test was analyzed by ROC curve.
In histopathology, 83 patients (81/4%) had acute appendicitis and 19 (18/6%) had normal appendices. Considering 14 mg/lit as the cut-off point, this test shows 59% (95% CI, 48-69%) sensitivity and 68% (95% CI, 47-88%) specificity. The positive and negative predictive values were 89% (95% CI, 80-97%) and 27% (95% CI, 14-39%), respectively.
The measurement of CRP levels is not an ideal diagnostic tool for ruling out or determination of acute appendicitis.
阑尾切除术是全球最常见的外科手术之一。尽管有各种实验室检查和影像学研究可提高诊断准确性，但阴性阑尾切除术的发生率仍约为15%至30%。本研究旨在评估定量C反应蛋白（CRP）在疑似急性阑尾炎患者中的诊断价值。
在一项前瞻性研究中，收集了102例患者阑尾切除术前的血样。采用免疫比浊法测定CRP，并将数据与最终的组织病理学报告进行比较。通过ROC曲线分析CRP检测的诊断准确性。
组织病理学检查中，83例（81.4%）患者患有急性阑尾炎，19例（18.6%）患者阑尾正常。以14mg/L为临界值，该检测的灵敏度为59%（95%CI，48%-69%），特异度为68%（95%CI，47%-88%）。阳性预测值和阴性预测值分别为89%（95%CI，80%-97%）和27%（95%CI，14%-39%）。
CRP水平的测定并非排除或确诊急性阑尾炎的理想诊断工具。
