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Diagnostic value of ROC curve evaluation of serum markers in acute cholecystitis with bacterial infection

Duo Li1, Zhu Yue1, Yibing Weng1

  • 1Department of Clinical Care Medicine, Beijing Luhe Hospital, Capital Medical University, China.

JPMA. the Journal of the Pakistan Medical Association
|June 25, 2022
PubMed

Insights

Serum human neutrophil lipocalin and C-reactive protein effectively diagnose bacterial infections in acute cholecystitis. Their combined use offers high sensitivity and specificity for early detection and monitoring.

Area of Science:

  • Biochemistry
  • Medical Diagnostics
  • Infectious Diseases

Background:

  • Acute cholecystitis is an inflammation of the gallbladder, often associated with bacterial infection.
  • Accurate and early diagnosis is crucial for effective treatment and patient outcomes.
  • Biomarkers such as human neutrophil lipocalin (HNL) and C-reactive protein (CRP) are investigated for their diagnostic potential.

Purpose of the Study:

  • To investigate the correlation between serum HNL and CRP levels and bacterial infection in acute cholecystitis.
  • To evaluate the diagnostic accuracy of HNL and CRP, individually and in combination, for bacterial infection-associated acute cholecystitis.

Main Methods:

  • A cross-sectional study involving 145 acute cholecystitis patients, divided into bacterial infection (Group A) and non-bacterial infection (Group B) groups.
  • Serum HNL and CRP levels were measured in both groups.
  • Receiver operating characteristic (ROC) curve analysis was employed to assess diagnostic value.

Main Results:

  • Serum HNL and CRP levels were significantly higher in Group A (bacterial infection) compared to Group B (p<0.001).
  • A strong positive correlation was observed between HNL and CRP in Group A (r=0.800, p<0.001).
  • The combined HNL and CRP markers demonstrated a high diagnostic accuracy (Area Under Curve=0.901) with 95.40% sensitivity and 80% specificity for bacterial infection.

Conclusions:

  • Combined serum HNL and CRP levels serve as effective indicators for the early diagnosis of acute cholecystitis with bacterial infection.
  • These markers aid in the identification and monitoring of bacterial infections complicating acute cholecystitis.
  • The synergistic diagnostic value of HNL and CRP surpasses their individual capabilities.
Abstract

Keywords:
Acute cholecystitis, Bacterial infection, C-reactive protein, Human neutrophil lipocalin, Receiver operating characteristic.

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