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| 1 | Measurement of calprotectin in ascitic fluid to identify elevated polymorphonuclear cell count显示文摘AIM: To evaluate the diagnostic capability of calprotectin in ascitic fluid for detecting a polymorphonuclear (PMN) cell count > 250/μL ascites. METHODS: In this prospective observational study, a total of 130 ascites samples were analysed from 71 consecutive patients referred for paracentesis. Total and differential leukocyte cell counts were determined manually with a Neubauer chamber and gentianviolet stain. Calprotectin was measured in 1 mL ascetic fluid by enzyme-linked immunosorbent assay (ELISA) and a point-of-care (POC) lateral flow assay with the Quantum Blue Reader (Bühlmann Laboratories). All measurements were carried out in a central laboratory by senior personnel blinded to patient history. A PMN count > 250/μL was the primary endpoint of the study. The diagnostic value of ascitic calprotectin measurement was assessed by comparing to the final diagnosis of each patient that had been adjudicated by investigators blinded to calprotectin values. RESULTS: The PMN count was > 250/μL in 19 samples (14.6%) from 15 patients (21.1%) and varied widely among the study population (range 10-19 800/mL and 1-17 820/mL, respectively). Spontaneous bacterial peritonitis (SBP) was the final diagnosis in four patients (5.6%). All patients with PMN ≤ 250/μL had negative bacterial culture. PMN count was elevated in five patients with peritoneal carcinomatosis, three with lymphoma, one with neuroendocrine carcinoma, and two with secondary peritonitis due to abdominal perforation. PMN cell counts correlated with ascitic calprotectin values (Spearman's rho; r = 0.457 for ELISA, r = 0.473 for POC). A considerable range of ascitic calprotectin concentrations was detected by ELISA [median 0.43 μg/mL, interquartile range (IQR) 0.23-1.23 (range 0.10-14.93)] and POC [median 0.38 μg/mL, IQR 0.38-0.56 (range 0.38-13.31)]. Ascitic calprotectin levels were higher in samples with PMN > 250/μL, by both ELISA [median (IQR) 2.48 μg/mL (1.61-3.65) vs 0.10 μg/mL (0.10-0.36), P < 0.001] and POC [2.78 μg/mL (2.05-5.37) vs 0.38 μg/mL (0.38-0.41), P < 0.001]. The area under the receiver operating characteristics curve for identifying an elevated PMN count was 0.977 (95%CI: 0.933 to 0.995) for ELISA and 0.982 (95%CI: 0.942 to 0.997) for POC (P = 0.246 vs ELISA). Using the optimal cut-off value for ELISA (0.63 μg/mL), ascitic calprotectin had 94.8% sensitivity, 89.2% specificity, positive and negative likelihood ratios of 8.76 and 0.06 respectively, positive and negative predictive values of 60.0% and 99.0% respectively, and 90.0% overall accuracy. Using the optimal cut-off value for POC (0.51 μg/mL), the respective values were 100.0%, 84.7%, 6.53, 0.00, 52.8%, 100% and 87.7%. Correlation between ELISA and POC was excellent (r = 0.873, P < 0.001). The mean ± SD of the difference was -0.11 ± 0.48 μg/mL with limits of agreement of + 0.8 μg/mL (95%CI: 0.69 to 0.98) and -1.1 μg/mL (95%CI: -1.19 to -0.91). CONCLUSION: Ascitic calprotectin reliably predicts PMN count > 250/μL, which may prove useful in the diagnosis of SBP, especially with a readily available bedside testing device. | Emanuel Burri Felix Schulte Jürgen Muser Rémy Meier Christoph Beglinger | 2013 | World Journal of Gastroenterology2013，19，13： | 10 |
| 2 | Vertex-distinguishing proper edge-colorings显示文摘 | BURRIS A C SCHELP R H | 1997 | J Graph Theory1997，26，2： | 1 |
| 3 | Leadership behavior and employee voice: Is the door really open?显示文摘 | Detert J R Burris E R | 2007 | Academy of Management Journal2007，50，4： | 1 |
| 4 | Can 1 microg of cosyntropin be used to evaluate adrenal insufficiency in critically ill patients? 显示文摘 | Kozyra E F Wax R S Burry L D | 2005 | Ann Pharmacother2005，39，4： | 1 |
| 5 | CO2 utilization as an oxidant in the dehydrogenation of ethylbenzene to styrene over MnO2-ZrO2 catalysts显示文摘 | Burri D R Choi K W Han D | 2006 | Catalysis Today2006，115，14： | 1 |
| 6 | The risks and rewards of speaking up: Managerial responses to employee voice 显示文摘 | Burris E R | 2012 | Academy of Management Journal2012，55，4： | 1 |
| 7 | Wet and dry coating structure of calcium carbonate pigments with narrow particle size distribution 显示文摘 | Knappich R Burri P Lohmuller G | 2000 | Tappi J2000，83，2： | 1 |
| 8 | Leadership behavior and em- ployee voice: Is the door really open 显示文摘 | Detert J R Burris E R | 2007 | Academy of Management Journal2007，50，4： | 1 |
| 9 | Multifunetionality of sin- gle-walled carbon nanotube- polytetra? uoroethylene nano- composites 显示文摘 | Vail J R Burris D L Sawyer W G | 2009 | Wear2009，267，14： | 1 |
| 10 | Can 1 microg of cosyntropin be used to evaluate adrenal insufiqciency in critically ill patients 显示文摘 | Kozyra E F Wax R S Burry L D | 2005 | Ann Pharma- cother2005，39，4： | 1 |
| 11 | Fluid resuscitation in a model of uncontrolled hemorrhage:too much too early ,or little too late?显示文摘 | Leppanliemi A soltero R Burris D | 1996 | J Surg Res1996，63，2： | 1 |
| 12 | Vertex-distinguishing proper edge-colorings显示文摘 | BURRIS A C SCHELP R H | 1997 | J Graph Theory1997，26，2： | 1 |
| 13 | Passive optical monitor for atmospheric turbulence and windspeed 显示文摘 | Stell M F Moore C I Burris H R | 2003 | Proceedings of the SPIE2003，5160，： | 1 |
| 14 | Quitting before leaving: The mediating effects of psychological attach- ment and detachment on voice 显示文摘 | Burris E R Detert J R Chiaburu D S | 2008 | Journal of Applied Psychology2008，4，93： | 1 |
| 15 | Leadership behavior and employeevoice: Is the door really open 显示文摘 | DetertJ R Burris E R | 2007 | Academy of Manage-ment Journal:2007，50，4： | 1 |
| 16 | Gasoline composition determined by1H NMR spectroscopy显示文摘 | BURRI J CROCKETT R HANY R | 2004 | Fuel2004，83，2： | 1 |
| 17 | Leadership behavior and employee voice: is the door really open? 显示文摘 | Detert J R Burris E R | 2007 | Academy of Management Journal2007，50，4： | 1 |
| 18 | Reduction of Vinyl Chlorinated in Metallic Iron-Water System 显示文摘 | Deng B Burris D R Campbell T | 1999 | Environ Sci & Technol1999，33，15： | 1 |
| 19 | Leadership Behavior and Employee Voice: Is the Door Really Open? 显示文摘 | DETERT J R BURRIS E R | 2007 | Academy of Management Journal2007，50，4： | 1 |
| 20 | Vertex-distinguishing proper edge-colorings 显示文摘 | Burris A C Schelp R H | 1997 | J Graph Theory1997，26，2： | 1 |
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