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Progranulin as a novel biomarker in diagnosis of early-onset neonatal sepsis
Cytokine ( IF 3.8 ) Pub Date : 2020-04-01 , DOI: 10.1016/j.cyto.2020.155000
Lubei Rao 1 , Zhixin Song 1 , Xiaoyan Yu 1 , Qianqian Tu 1 , Yu He 2 , Yetao Luo 3 , Yibing Yin 4 , Dapeng Chen 1
Affiliation  

BACKGROUND Infections are leading causes of morbidity and mortality in neonates and may also have severe long-term consequences. As early diagnosis of neonatal sepsis improves prognosis, identification of new or complementary biomarkers is of great importance. In this study, we have evaluated the diagnostic value of progranulin (PGRN) in early-onset neonatal sepsis (EOS) and compare its effectiveness with other commonly used biomarkers, such as procalcitonin (PCT) and C-reactive protein (CRP). METHODS A total of 121 infants with gestational age of >34 weeks admitted with suspected EOS were included in this study. Before initiating therapy, blood samples for whole blood count, CRP, PCT and PGRN were obtained from all neonates. Receiver-operating characteristic (ROC) curve and multivariate logistic regression analyses were performed. RESULTS Serum PGRN level of infected group was significantly higher than uninfected group (median 47.72 vs. 37.86 ng/ml, respectively; Mann-Whitney p < 0.0001). The ROC area under the curve (AUC) was 0.786 [95% confidence interval (CI) 0.706-0.867; p < 0.0001] for PGRN, 0.699 (95% CI 0.601-0.797; p = 0.0001) for age adjusted PCT, and 0.673 (95% CI 0.573-0.773; p = 0.0007) for CRP. With a cut-off value of 37.89 ng/ml, the diagnostic sensitivity and negative predictive value of PGRN were 94.34% and 91.7%, respectively. PGRN could significantly predict EOS independently of PCT (p < 0.0001), and the combined use of PGRN and PCT could significantly improve diagnostic performance for EOS (0.806; 95% CI 0.73-0.88; p < 0.0001), with a specificity of 89.06% and a positive predictive value of 81.10%. CONCLUSIONS PGRN may be used as a promising biomarker for the diagnosis of EOS, and the combined use of PGRN and PCT could improve the diagnosis of sepsis.

中文翻译:

颗粒蛋白前体作为诊断早发性新生儿败血症的新型生物标志物

背景感染是新生儿发病和死亡的主要原因,并且还可能具有严重的长期后果。由于新生儿败血症的早期诊断可改善预后,因此鉴定新的或互补的生物标志物非常重要。在本研究中,我们评估了颗粒蛋白原 (PGRN) 在早发性新生儿败血症 (EOS) 中的诊断价值,并将其与其他常用生物标志物,如降钙素原 (PCT) 和 C 反应蛋白 (CRP) 的有效性进行了比较。方法 本研究共纳入 121 名孕龄 >34 周且疑似 EOS 的婴儿。在开始治疗之前,从所有新生儿中获取全血细胞计数、CRP、PCT 和 PGRN 的血样。进行了受试者工作特征(ROC)曲线和多变量逻辑回归分析。结果 感染组的血清 PGRN 水平显着高于未感染组(中值分别为 47.72 和 37.86 ng/ml;Mann-Whitney p < 0.0001)。ROC 曲线下面积 (AUC) 为 0.786 [95% 置信区间 (CI) 0.706-0.867;p < 0.0001] 对于 PGRN,年龄调整后的 PCT 为 0.699(95% CI 0.601-0.797;p = 0.0001),CRP 为 0.673(95% CI 0.573-0.773;p = 0.0007)。截断值为 37.89 ng/ml,PGRN 的诊断灵敏度和阴性预测值分别为 94.34% 和 91.7%。PGRN 可以独立于 PCT 显着预测 EOS(p < 0.0001),并且联合使用 PGRN 和 PCT 可以显着提高 EOS 的诊断性能(0.806;95% CI 0.73-0.88;p < 0.0001),特异性为 89.06%阳性预测值为 81.10%。
更新日期:2020-04-01
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