Serum and Urine Biomarker Leucine-Rich Alpha-2 Glycoprotein 1 Differentiates Pediatric Acute Complicated and Uncomplicated Appendicitis

Mohit Kakar (Coresponding Author), Marisa Maija Berezovska, Renars Broks, Lasma Asare, Mathilde Delorme, Emile Crouzen, Astra Zviedre, Aigars Reinis, Arnis Engelis, Juta Kroica, Amulya Saxena, Aigars Petersons

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Abstract

Purpose: This prospective, single-center cohort study analyzes the potential of inflammatory protein mediator leucine-rich alpha-2 glycoprotein 1 (LRG1) for the early and accurate diagnosis of acute appendicitis (AA), and differentiation of acute complicated (AcA) from uncomplicated appendicitis (AuA). Methods: Participants were divided into the AcA, AuA, and control groups, and their serum (s-LRG1) and urine LRG1 (u-LRG1) levels were assayed preoperatively on the second and fifth postoperative days. Results: 153 patients participated, 97 had AA. Preoperative u-LRG1 with a cut-off value of 0.18 µg/mL generated an area under the receiver operated characteristic (AUC) curve of 0.70 (95% CI 0.62–0.79) for AA versus control (p < 0.001), while the results for AcA versus AuA were not significant (AUC 0.60, 95% CI 0.49–0.71, p = 0.089). The s-LRG1 levels of AA versus the control with a cut-off value of 51.69 µg/mL generated an AUC of 0.94 (95% CI 0.91–0.99, p < 0.001). The cut-off value of s-LRG1 was 84.06 µg/mL for diagnosis of AcA from AuA, and therefore, significant (AUC 0.69, 95% CI 0.59–0.80, p = 0.001). Conclusions: LRG1 exhibited excellent diagnostic performance as an inexpensive, non-invasive, rapid, and accurate biomarker able to reflect the pathogenesis of AA. LRG1 has the potential to replace advanced imaging to diagnose clinically ambiguous AA cases.
Original languageEnglish
Article number860
Number of pages12
JournalDiagnostics
Volume11
Issue number5
DOIs
Publication statusPublished - 11 May 2021

Keywords

  • pediatric appendicitis
  • biomarkers
  • serum LRG1
  • urine LRG1

Field of Science

  • 3.2 Clinical medicine

Publication Type

  • 1.4. Reviewed scientific article published in Latvia or abroad in a scientific journal with an editorial board (including university editions)

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