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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 | Glucagon-like peptide 1 increases secretory burst mass of pulsatile insulin secretion in patients with type 2 diabetes and impaired glucose tolerance显示文摘 | Ritzel R Schulte M Nauck M A | 2001 | Diabetes2001，50，： | 2 |
| 3 | Association of hypertensive status and its drug treatment with lipid and haemostatic factors in middle-aged men: the PRIME study显示文摘 | Junker R Heinrich J Schulte H | 2000 | J Hum Hypert2000，14，： | 1 |
| 4 | Folded Optical Delay Lines 显示文摘 | Herriott D R Schulte J | 1965 | Applied Optics1965，4，8： | 1 |
| 5 | Minor constituents of vegetable oils during industrial processing 显示文摘 | FERRARI R A SCHULTE E ESTEVES W | 1996 | J Am Oil Chem Soc1996，73，5： | 1 |
| 6 | Two-phase nanoscale morphology of polyme:r/LC composites显示文摘 | Vaia R A Tomlin D W Schulte M D | 2001 | Polymer2001，42，3： | 1 |
| 7 | Effect of prolonged physical exercise on fluid regulating hormones显示文摘 | H. U. Altenkirch R. Gerzer K. A. Kirsch J. Weil B. Heyduck I. Schultes L. R?cker | 1990 | European Journal of Applied Physiology and Occupational Physiology (-)1990，，3： | 1 |
| 8 | Design and rapid protolyping of thin-film laminate-based microfluidic de- vices 显示文摘 | WEIGL B H BARDELL R SCHULTE T | 2010 | Biomedical Microdevices2010，3，4： | 1 |
| 9 | ΣPAH:A Model to predict the toxicity of polynuclear aromatic hydrocarbon mixtures in field-collected sediments显示文摘 | Swartz R C Schults D W Ozretich R J | 1995 | Environmental Toxicology and Chemistry1995，14，11： | 1 |
| 10 | Association ofvariables of coagulation,fibrinolysis and acute-phase with atherosclerosis in coronary and peripheral arteries and those arteries supplying 显示文摘 | Heinrich J Schulte H Schonfeld R | 1995 | the brain Thromb Haemost1995，73，： | 1 |
| 11 | Longevity of ceramic inlays and onlays luted with a solely light-curing composite resin显示文摘 | Vockler A Reinhardt R | 2005 | J Dent2005，33，5： | 1 |
| 12 | Association of variables of coagula-Tion,fibrinolysis and acute-phase with atherosclerosis in coronary and peripheral arteries and those arteries supplying the brain显示文摘 | Heinrich J Schulte H Schonfeld R | 1995 | Thromb Haemost1995，74，3： | 1 |
| 13 | Prediction of risk of coronary events in middle-aged men in the Prospective Cardiovascular Munster Study (PROCAM) using neural networks显示文摘 | Voss R Cullen P Schulte H | 2002 | Int J Epidemiol2002，31，6： | 1 |
| 14 | Maize high chlorophyll fluorescent 60 mutantion is caused by an Ac disruption of the gene encoding the chloroplast ribosomal small subunit protein 17显示文摘 | Schultes P Sawers R J H Brutnell T P Krueger R W | 2000 | Plant J2000，21，4： | 1 |
| 15 | Evolution and phylogenetic information content of mitochondrial genomic structural features illustrated with acrodont lizards显示文摘 | Macey J R Schulte J A Larson A | 2000 | Systematic Biology2000，49，2： | 1 |
| 16 | Three-dimensional desingularized boundary integral method for potential problem显示文摘 | I Cao Y S Schults W W Beck R F | 1991 | International Journal for Numerical Methods in Fluids1991，12，8： | 1 |
| 17 | Central nervous system dis- ease in patients with systemic lupus erythematosus显示文摘 | Futrell N Schults L R Millikan C | 1992 | Neurolo- gy1992，42，9： | 1 |
| 18 | Associationofcoagulatio n,Fibrinolysis and acute phase with atherosclerosis in coronary and peripheral arteries and those arteries supplying the brain显示文摘 | Heinrich J Schulte H Schonfeld R | 1995 | Thrombi Haemost1995，73，3： | 1 |
| 19 | Role of WNT-5a in the determination of human mesenchymal stem cells into preadipocytes 显示文摘 | Bilkovski R Schulte DM Oberhauser F | 2010 | J Biol Chem2010，285，9： | 1 |
| 20 | Prognostic factors for local control and survival after radiotherapy of metastatic spinal cord compression显示文摘 | Rades D Fehlauer F Schulte R | 2006 | J Clin Oncol2006，24，21： | 1 |
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