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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 | Improvements in survival and clinical benefit with gemcitabine as firstline therapy for patients with advanced pancreatic cancer: a randomized trial显示文摘 | Burris HA Ⅲ Moore MJ Anderson J | 1997 | J Clin Oncol1997，15，6： | 1 |
| 3 | Umbilical artery acid-base status in the preterm infant显示文摘 | Ramin SM Gilstrap LC Leveno K J Burris J Little BB | 1989 | Obstet Gynecol1989，74，2： | 1 |
| 4 | Improvements in sur- vival and clinical benefit with gemeitabine as first-line therapy for patients with advanced pancreas cancer:a randomized trial 显示文摘 | Burris HA 3^rd Moore MJ Andersen J | 1997 | J Clin Oncal1997，15，： | 1 |
| 5 | 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 |
| 6 | GaInSn usage in the research laboratory 显示文摘 | Morley N B Burris J Cadwallader L C | 2008 | Review of Scientific Instru- ments2008，79，05： | 1 |
| 7 | Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial 显示文摘 | Burris HA 3rd Moore M J Andersen J | 1997 | J Clin Oncol1997，15，6： | 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 | Gonadotropin therapy in men with isolated hypogonadotropic hypogonadism: the response to human chorionic Gonadotropin is predicted by initial testicular size显示文摘 | Burris AS Rodbard HW Winters S J | 1988 | Clin Endocrinol Metab1988，66，6： | 1 |
| 10 | Improvements in survival and clinical benefit with gemcitabine as first-line theraphy for patients with advanced pancreas cancer:a randomized trial显示文摘 | Burris H Moore M J Anderson J | 1997 | Journal of Clinical Oncology1997，15，4： | 1 |
| 11 | 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 |
| 12 | Improvements in survival and clinical benefit with gemcitabine flrst-time therapy for patients with advanded pancreas cancer: Arandimized trial显示文摘 | Burris HA Moore MJ Andersen J | 1997 | J Clin Oncol1997，15，： | 1 |
| 13 | Linear - quadratic guidance law for dual control of homing missiles 显示文摘 | D G Hull J L Speyer D B Burris | 1990 | AIAA Journal of Guid- ance Control and Dynamics1990，13，1： | 1 |
| 14 | Phase I,dose-escalation study of BKM120, an oral pan-Class I PI3Kinhibitor, in patients with advanced solid tumors 显示文摘 | Bendell JC Rodon J Burris HA | 2012 | J ClinOncol2012，30，3： | 1 |
| 15 | Improve- ments in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial显示文摘 | Burris HA 3rd Moore M J Andersen J | 1997 | J Clin Oncol1997，15，6： | 1 |
| 16 | Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial 显示文摘 | Burris HA 3rd Moore MJ Andersen J | 1997 | J Clin Oncol1997，15，6： | 1 |
| 17 | Im- provements in survival and clinical benefit with gemcit- abine as first-line therapy for patients with advanced pancreas cancer: a randomized trial显示文摘 | BURRIS H A MOORE M J ANDERSEN J | 1997 | J Clin Oncol1997，15，： | 1 |
| 18 | Rituximab as first-line and maintenance therapy for patients with indolent non-Hodgkin ' s lymphoma 显示文摘 | HAINSWORTH J D LITCHY S BURRIS H A | 2002 | JCO2002，20，20： | 1 |
| 19 | Improvements in sur- vival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized tri- al 显示文摘 | Burris H Moor M Auderson J | 1997 | J Clin Oneol1997，5，6： | 1 |
| 20 | Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer:A randomized trial显示文摘 | Burris HA 3rd Moore MJ Andersen J | 1997 | J Clin Oncol1997，15，6： | 1 |
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