5-羟吲哚乙酸作为揭示急性阑尾炎穿孔的生物标志物。

5-Hydroxyindoleacetic acid as a biomarker for revealing perforation in acute appendicitis.

机构信息

Department of General Surgery, Imam Hosein Medical and Educational Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of General Surgery, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

BMC Gastroenterol. 2024 Oct 14;24(1):366. doi: 10.1186/s12876-024-03451-0.

DOI:10.1186/s12876-024-03451-0

PMID:39402472

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11472468/

Abstract

BACKGROUND

The present study investigated the level of 5-hydroxyindoleacetic acid (5-HIAA) in perforated and nonperforated appendicitis patients. This issue is important for timely diagnosis of acute appendicitis complications and making decision about the surgical plan and type of incision.

METHODS

This prospective study was conducted on patients with acute appendicitis. 5-HIAA levels were measured in urine spot sample of every patient before the surgery. The patients were finally included based on result of pathology for presence of appendicitis or not and sorted by direct surgical detection for exist of perforation or not. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 5-HIAA were investigated. The data were statistically analyzed by SPSS v.27.

RESULTS

A total of 150 patients were included in two groups as 40 patients in the perforated appendicitis group and 110 patients in the noncomplicated acute appendicitis group. The average age of patients in the perforated appendicitis group was 28.8 ± 6.07 years, and that of patients in the acute appendicitis group was 29.6 ± 6.96 years. 94 patients (63%) were male, and 56 (37%) were female. No significant difference was observed in terms of age or sex between the two groups. The difference in the 5-HIAA concentration between the acute appendicitis group (0.3 ± 0.04 mg/dl) and the perforated appendicitis group (0.5 ± 0.03 mg/dl) was significant (P < 0.001). The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 82%, 62%, 75%, 77%, and 88% respectively.

CONCLUSION

This study shows that the 5-HIAA concentration in patients with perforated appendicitis can potentially increased significantly more than that in patients in the early stages of acute appendicitis. further studies with larger sample sizes are needed to prove the present results.

摘要

背景

本研究调查了穿孔性和非穿孔性阑尾炎患者 5-羟吲哚乙酸（5-HIAA）的水平。这一问题对于及时诊断急性阑尾炎并发症以及决定手术计划和切口类型非常重要。

方法

这是一项前瞻性研究，纳入了急性阑尾炎患者。每位患者在手术前采集尿样检测 5-HIAA 水平。根据病理结果是否存在阑尾炎，以及直接手术探查是否存在穿孔，将患者最终纳入研究。研究调查了 5-HIAA 的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性。数据采用 SPSS v.27 进行统计学分析。

结果

共有 150 例患者分为两组，穿孔性阑尾炎组 40 例，非复杂性急性阑尾炎组 110 例。穿孔性阑尾炎组患者的平均年龄为 28.8±6.07 岁，急性阑尾炎组为 29.6±6.96 岁。94 例（63%）为男性，56 例（37%）为女性。两组患者在年龄和性别方面无显著差异。急性阑尾炎组（0.3±0.04mg/dl）和穿孔性阑尾炎组（0.5±0.03mg/dl）的 5-HIAA 浓度差异显著（P<0.001）。敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 82%、62%、75%、77%和 88%。