Akut apandisitli çocuklarda serum pentraksin 3 düzeyinin tanýsal deðeri

AMAÇ: Apandisit en sýk görülen cerrahi acillerden biridir. Çocuklarda apandisitin erken tanýsý önemlidir, çünkü tedavideki herhangi bir gecikme büyük ölçüde komplike apandisite yol açar. Bu çalýþmada, akut apandisitli çocuklarda pentraksin 3 (PTK3) düzeyinin tanýsal deðerini ve hastalýðýn ilerlemesi ile PTK3 seviyesi arasýnda bir iliþki olup olmadýðýný araþtýrmayý amaçladýk.
GEREÇ VE YÖNTEM: Bu çalýþmaya 70 çocuk alýndý. Çocuklar 3 gruba ayrýldý: Grup 1 (apandisit; n=37), grup 2 (karýn aðrýsý; n=25), grup 3 (kontrol; n=8). Demografik veriler, týbbi öykü, semptomlarýn baþlangýcýndan kan örneklemesine kadar geçen süre, hastalarýn ameliyat ve patolojik bulgularý kaydedildi ve beyaz küre (BK), C-reaktif protein (CRP) ve PTK3 deðerleri ölçüldü.
BULGULAR: Apandisit grubunda ortalama BK, CRP ve PTK3 deðerleri anlamlý olarak yüksek bulundu (p<0.001). Apandisit grubunda PTK3 en yüksek taný deðerine (AUC=0.828), özgüllüðe (%88) ve pozitif öngörü deðerine (%90) sahipti. BK deðerleri zaman dilimleri ile anlamlý bir korelasyon göstermedi (p=0.999). Apandisit grubunda 24–48 saatteki ortalama CRP deðeri, 0–24 saattekinden daha yüksek bulundu, ancak bu sýnýrda anlamlý idi (p=0.068). Diðer taraftan, PTK3 deðeri zaman dilimleri ile anlamlý olarak korele idi (p<0.05).
TARTIÞMA: Bu çalýþma, PTK3’ün akut apandisit tanýsýnda deðerli bir enflamatuvar biyobelirteç olduðunu göstermiþ ve ayrýca hastalýðýn ilerlemesini tahmin etmek için de yararlý olduðunu belgelemiþtir.

Diagnostic value of serum pentraxin 3 level in children with acute appendicitis

BACKGROUND: Appendicitis is one of the most common surgical emergencies. Early diagnosis of appendicitis is important in children because any delay in treatment substantially leads to complicated appendicitis. In this study, we aimed to test the diagnostic value of pentraxin 3 (PTX3) level in children with acute appendicitis and to investigate whether there is a relationship between the progression of the disease and PTX3 level.
METHODS: This prospective study included 70 children. They were divided into three groups as follows: group 1 (appendicitis; n=37), group 2 (abdominal pain; n=25), group 3 (control; n=8). Demographic data, medical history, the time from the onset of symptoms to blood sampling, operative and pathological findings of the patients were noted, and white blood cell (WBC), C-reactive protein (CRP) and PTX3 values were measured.
RESULTS: The mean WBC, CRP and PTX3 values were found to be significantly increased in the appendicitis group (p<0.001). PTX3 has the highest diagnostic value (AUC=0.828), specificity (88%) and positive predictive value (90%) in the appendicitis group. WBC values did not show a significant correlation with the time periods (p=0.999). The mean CRP level of the appendicitis group in 24–48 hours was found to be higher than in 0–24 hours, but this was marginally significant (p=0.068). On the other hand, PTX3 value was significantly correlated with the time periods (p<0.05).
CONCLUSION: This study showed that PTX3 is a valuable inflammatory biomarker in the diagnosis of acute appendicitis and also documented that PTX3 is useful for predicting the progression of the disease.