Diagnostic Accuracy of Leucine-Rich α-2-Glycoprotein 1 as a Non-Invasive Salivary Biomarker in Pediatric Appendicitis
The aim of this study is to evaluate the diagnostic accuracy of leucine-rich α-2-glycoprotein 1 (LRG1) in saliva as a novel biomarker for acute appendicitis in the pediatric population. From October 2021 to June 2022, 92 children aged 5 to 17 years who presented with acute abdomen and suspected acut...
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| Format: | Article |
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MDPI AG
2023-03-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/7/6043 |
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| author | Goran Tintor Miro Jukić Daniela Šupe-Domić Ana Jerončić Zenon Pogorelić |
| author_facet | Goran Tintor Miro Jukić Daniela Šupe-Domić Ana Jerončić Zenon Pogorelić |
| author_sort | Goran Tintor |
| collection | DOAJ |
| description | The aim of this study is to evaluate the diagnostic accuracy of leucine-rich α-2-glycoprotein 1 (LRG1) in saliva as a novel biomarker for acute appendicitis in the pediatric population. From October 2021 to June 2022, 92 children aged 5 to 17 years who presented with acute abdomen and suspected acute appendicitis were enrolled in this prospective study. The parameters documented included demographic and clinical information, as well as operative and postoperative data. Patients were divided into two groups: those with acute appendicitis who underwent laparoscopic appendectomy (<i>n</i> = 46) and those without appendicitis (<i>n</i> = 46). The total white blood cell (WBC) count, percent of neutrophils, C-reactive protein (CRP) level, and salivary LRG1 were compared between groups. A commercially available enzyme-linked immunosorbent assay (ELISA) LRG kit was used to measure the LRG levels. The median salivary LRG1 level was significantly higher in the group of children with pathohistologically confirmed acute appendicitis compared to the control group: 233.45 ng/mL (IQR 114.9, 531.2) vs. 55.95 ng/mL (IQR 51.5, 117.9), <i>p</i> < 0.001. LRG1 had an overall good receiver-operator characteristic area under the curve of 0.85 (95% CI 0.76–0.92; <i>p</i> < 0.001). The optimal LRG1 cutoff with best separation between acute appendicitis and the controls was >352.6 ng/mL (95% CI from >270.7 to >352.6). Although the specificity was 100% at this cutoff, the sensitivity for identifying appendicitis was 36%. In addition, a significant difference was found between groups in the laboratory values of all inflammatory markers tested: WBC, absolute neutrophil count, and CRP (<i>p</i> < 0.001 for all). Although LRG1 in saliva showed a good AUC parameter and significantly higher values in patients with acute appendicitis compared to the controls, its usefulness in the patient population who present at emergency departments with abdominal pain is debatable. Future studies should focus on investigating its diagnostic potential. |
| first_indexed | 2024-03-11T05:36:31Z |
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| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-11T05:36:31Z |
| publishDate | 2023-03-01 |
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| series | International Journal of Molecular Sciences |
| spelling | doaj.art-1717c974c9c24dd28ab023e9130d8c392023-11-17T16:45:36ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-03-01247604310.3390/ijms24076043Diagnostic Accuracy of Leucine-Rich α-2-Glycoprotein 1 as a Non-Invasive Salivary Biomarker in Pediatric AppendicitisGoran Tintor0Miro Jukić1Daniela Šupe-Domić2Ana Jerončić3Zenon Pogorelić4Department of Plastic Reconstructive and Aesthetic Surgery, University Hospital of Split, 21 000 Split, CroatiaDepartment of Surgery, School of Medicine, University of Split, 21 000 Split, CroatiaDepartment of Medical Laboratory Diagnostics, University Hospital of Split, 21 000 Split, CroatiaDepartment of Research in Biomedicine and Health, School of Medicine, University of Split, 21 000 Split, CroatiaDepartment of Surgery, School of Medicine, University of Split, 21 000 Split, CroatiaThe aim of this study is to evaluate the diagnostic accuracy of leucine-rich α-2-glycoprotein 1 (LRG1) in saliva as a novel biomarker for acute appendicitis in the pediatric population. From October 2021 to June 2022, 92 children aged 5 to 17 years who presented with acute abdomen and suspected acute appendicitis were enrolled in this prospective study. The parameters documented included demographic and clinical information, as well as operative and postoperative data. Patients were divided into two groups: those with acute appendicitis who underwent laparoscopic appendectomy (<i>n</i> = 46) and those without appendicitis (<i>n</i> = 46). The total white blood cell (WBC) count, percent of neutrophils, C-reactive protein (CRP) level, and salivary LRG1 were compared between groups. A commercially available enzyme-linked immunosorbent assay (ELISA) LRG kit was used to measure the LRG levels. The median salivary LRG1 level was significantly higher in the group of children with pathohistologically confirmed acute appendicitis compared to the control group: 233.45 ng/mL (IQR 114.9, 531.2) vs. 55.95 ng/mL (IQR 51.5, 117.9), <i>p</i> < 0.001. LRG1 had an overall good receiver-operator characteristic area under the curve of 0.85 (95% CI 0.76–0.92; <i>p</i> < 0.001). The optimal LRG1 cutoff with best separation between acute appendicitis and the controls was >352.6 ng/mL (95% CI from >270.7 to >352.6). Although the specificity was 100% at this cutoff, the sensitivity for identifying appendicitis was 36%. In addition, a significant difference was found between groups in the laboratory values of all inflammatory markers tested: WBC, absolute neutrophil count, and CRP (<i>p</i> < 0.001 for all). Although LRG1 in saliva showed a good AUC parameter and significantly higher values in patients with acute appendicitis compared to the controls, its usefulness in the patient population who present at emergency departments with abdominal pain is debatable. Future studies should focus on investigating its diagnostic potential.https://www.mdpi.com/1422-0067/24/7/6043acute appendicitischildrensalivabiomarkerLRG1leucine-rich α-2-glycoprotein 1 |
| spellingShingle | Goran Tintor Miro Jukić Daniela Šupe-Domić Ana Jerončić Zenon Pogorelić Diagnostic Accuracy of Leucine-Rich α-2-Glycoprotein 1 as a Non-Invasive Salivary Biomarker in Pediatric Appendicitis International Journal of Molecular Sciences acute appendicitis children saliva biomarker LRG1 leucine-rich α-2-glycoprotein 1 |
| title | Diagnostic Accuracy of Leucine-Rich α-2-Glycoprotein 1 as a Non-Invasive Salivary Biomarker in Pediatric Appendicitis |
| title_full | Diagnostic Accuracy of Leucine-Rich α-2-Glycoprotein 1 as a Non-Invasive Salivary Biomarker in Pediatric Appendicitis |
| title_fullStr | Diagnostic Accuracy of Leucine-Rich α-2-Glycoprotein 1 as a Non-Invasive Salivary Biomarker in Pediatric Appendicitis |
| title_full_unstemmed | Diagnostic Accuracy of Leucine-Rich α-2-Glycoprotein 1 as a Non-Invasive Salivary Biomarker in Pediatric Appendicitis |
| title_short | Diagnostic Accuracy of Leucine-Rich α-2-Glycoprotein 1 as a Non-Invasive Salivary Biomarker in Pediatric Appendicitis |
| title_sort | diagnostic accuracy of leucine rich α 2 glycoprotein 1 as a non invasive salivary biomarker in pediatric appendicitis |
| topic | acute appendicitis children saliva biomarker LRG1 leucine-rich α-2-glycoprotein 1 |
| url | https://www.mdpi.com/1422-0067/24/7/6043 |
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