Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN.
LVPG Orthopedics and Sports Medicine, Lehigh Valley Health Network, Allentown, PA.
J Orthop Trauma. 2022 Oct 1;36(10):e380-e387. doi: 10.1097/BOT.0000000000002379.
To compare a large panel of plasma protein inflammatory biomarkers and mid-infrared (MIR) spectral patterns in patients with confirmed fracture-related infections (FRIs) with those in controls without infection.
Prospective case-control study.
Academic, Level 1 trauma center.
Thirteen patients meeting confirmatory FRI criteria were matched to 13 controls based on age, time after surgery, and fracture region.
Plasma levels of 49 proteins were measured using enzyme-linked immunosorbent assay techniques. Fourier transform infrared spectroscopy of dried films was used to obtain MIR spectra of plasma samples.
The main outcome measurements included plasma protein levels and MIR spectra of samples.
Multivariate analysis-based predictive model developed using enzyme-linked immunosorbent assay-based biomarkers had sensitivity, specificity, and accuracy of 69.2% ± 0.0%, 99.9% ± 1.0%, and 84.5% ± 0.6%, respectively, with platelet-derived growth factor-AB/BB, C-reactive protein, and MIG selected as the minimum number of variables explaining group differences ( P < 0.05). Sensitivity, specificity, and accuracy of the predictive model based on MIR spectra were 69.9% ± 6.2%, 71.9% ± 5.9%, and 70.9% ± 4.8%, respectively, with 6 wavenumbers as explanatory variables ( P < 0.05).
This pilot study demonstrates the feasibility of using a select panel of plasma proteins and Fourier transform infrared spectroscopy to diagnose FRIs. Preliminary data suggest that the measurement of these select proteins and MIR spectra may be potential clinical tools to detect FRIs. Further investigation of these biomarkers in a larger cohort of patients is warranted.
Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
比较一组大型血浆蛋白炎症生物标志物和中红外（MIR）光谱模式，以评估确诊的骨折相关感染（FRI）患者与无感染对照患者之间的差异。
前瞻性病例对照研究。
学术性、1 级创伤中心。
根据年龄、术后时间和骨折部位，将 13 名符合 FRI 确诊标准的患者与 13 名对照患者进行匹配。
采用酶联免疫吸附测定技术测量 49 种蛋白质的血浆水平。使用傅里叶变换红外光谱法对干燥的血浆样本进行光谱分析。
主要观察指标包括血浆蛋白水平和样本的 MIR 光谱。
基于酶联免疫吸附测定的生物标志物建立的多变量分析预测模型，其敏感性、特异性和准确性分别为 69.2%±0.0%、99.9%±1.0%和 84.5%±0.6%，血小板衍生生长因子 AB/BB、C 反应蛋白和 MIG 被选为解释组间差异的最小变量数（P < 0.05）。基于 MIR 光谱的预测模型的敏感性、特异性和准确性分别为 69.9%±6.2%、71.9%±5.9%和 70.9%±4.8%，6 个波数为解释变量（P < 0.05）。
这项初步研究证明了使用选定的血浆蛋白和傅里叶变换红外光谱诊断 FRI 的可行性。初步数据表明，这些选定蛋白和 MIR 光谱的测量可能是检测 FRI 的潜在临床工具。需要在更大的患者队列中进一步研究这些生物标志物。
诊断 IV 级。请参阅作者说明，以获取完整的证据水平描述。
