Farrugia Marwin A, Le Corvec Maëna, Renou Christophe, Nousbaum Jean-Baptiste, Ouizeman Dann J, Sire Olivier, Loréal Olivier, Tariel Hugues, Bernard Jérôme, Piche Thierry, Tran Albert, Ait-Oufella Hafid, Landraud Luce, Gual Philippe, Anty Rodolphe
Service d'Hépatologie, Centre Hospitalier Universitaire, Hôpital Archet 2, 151 Route de Saint-Antoine, 06000 Nice, France.
DIAFIR, Avenue Chardonnet, Parc Lorans 26J, 35000 Rennes, France.
Biomedicines. 2023 Mar 9;11(3):838. doi: 10.3390/biomedicines11030838.
A highly sensitive and specific point-of-care method for diagnosing spontaneous bacterial peritonitis (SBP) is currently lacking. The objective of the present study is to evaluate the diagnostic value of a rapid, easy-to-use, mid-infrared fiber evanescent wave spectroscopy (MIR-FEWS) method for ruling out SBP.
Cirrhotic patients ( = 256) at five centers in France were included for suspected SBP or for the scheduled evacuation of ascites fluid. The mid-infrared spectrum of 7 µL of an ascites fluid sample was recorded using a MIR-FEWS system. To define a model for the diagnosis of SBP, the patients were divided into a calibration group ( = 170) and a validation group ( = 86).
Most of the patients were male (71%). The mean age was 60.25 years. Alcohol-related liver disease was the most common cause of cirrhosis. SBP was observed in 18% of the patients. For the diagnosis of SBP in the calibration and validation groups, respectively, the model gave areas under the receiver operating characteristic curves of 0.87 and 0.89, sensitivities of 90% and 87%, specificities of 78% and 80%, positive predictive values of 48% and 50%, negative predictive values of 97% and 96%, positive likelihood ratio of 4.09 and 4.35, negative likelihood ratio of 0.13 and 0.16, Youden index of 0.68 and 0.67, and correct classification rates of 80% and 81%.
The results of this proof-of-concept study show that MIR-FEWS is a highly sensitive diagnostic method for ruling out SBP. The method warrants further investigation.
目前缺乏一种用于诊断自发性细菌性腹膜炎（SBP）的高灵敏度和特异性的即时检测方法。本研究的目的是评估一种快速、易用的中红外光纤倏逝波光谱法（MIR-FEWS）排除SBP的诊断价值。
法国五个中心的256例肝硬化患者因疑似SBP或计划抽取腹水而纳入研究。使用MIR-FEWS系统记录7微升腹水样本的中红外光谱。为确定SBP诊断模型，将患者分为校准组（170例）和验证组（86例）。
大多数患者为男性（71%）。平均年龄为60.25岁。酒精性肝病是肝硬化最常见的病因。18%的患者观察到SBP。在校准组和验证组中，该模型诊断SBP的受试者工作特征曲线下面积分别为0.87和0.89，灵敏度分别为90%和87%，特异性分别为78%和80%，阳性预测值分别为48%和50%，阴性预测值分别为97%和96%，阳性似然比分别为4.09和4.35，阴性似然比分别为0.13和0.16，约登指数分别为0.68和0.67，正确分类率分别为80%和81%。
这项概念验证研究的结果表明，MIR-FEWS是一种用于排除SBP的高灵敏度诊断方法。该方法值得进一步研究。
