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Diagnostic Value of Synovial Fluid Biomarkers for Periprosthetic Joint Infection: A Prospective, Double-blind Trial
BACKGROUND: This prospective, double-blind study investigated the clinical diagnostic value of synovial fluid S100 calcium-binding protein A8 (S100A8) and S100 calcium-binding protein A9 (S100A9) in periprosthetic joint infection (PJI) and investigated the subtypes of α-defensin that have diagnostic...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578642/ https://www.ncbi.nlm.nih.gov/pubmed/37814443 http://dx.doi.org/10.12659/MSM.940842 |
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author | Xu, Ying Ma, Xueting Guo, Haoran Tang, Hairong Liu, Jiayu Wang, Chengbin Wang, Chi |
author_facet | Xu, Ying Ma, Xueting Guo, Haoran Tang, Hairong Liu, Jiayu Wang, Chengbin Wang, Chi |
author_sort | Xu, Ying |
collection | PubMed |
description | BACKGROUND: This prospective, double-blind study investigated the clinical diagnostic value of synovial fluid S100 calcium-binding protein A8 (S100A8) and S100 calcium-binding protein A9 (S100A9) in periprosthetic joint infection (PJI) and investigated the subtypes of α-defensin that have diagnostic value for PJI. MATERIAL/METHODS: Synovial fluid samples were collected from 82 patients with suspected PJI after total joint arthroplasty. Patients were divided into a PJI group (n=39) and non-PJI group (n=43). Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was used to determine S100A8, S100A9, α-defensin, and internal reference standards in synovial fluid. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of S100A8, S100A9, and α-defensin for PJI, as well as the diagnostic value in combination with common biomarkers of infection. RESULTS: S100A8, 3 variants of S100A9, and 3 α-defensins (human neutrophil peptides [HNP]1–3) in synovial fluid were significantly higher in the PJI group than in the non-PJI group (P<0.001). The sensitivity, specificity, and the area under ROC curve (AUC) for diagnosing PJI were 97.4%, 86.0%, and 0.964 (95% CI: 0.929–0.998), respectively, for synovial fluid S100A8; 87.2%, 88.4% and 0.902 (95% CI: 0.823–0.980), respectively, for S100A9; and 89.7%, 83.7%, and 0.933 (95% CI: 0.884–0.982), respectively, for HNP1-3. The diagnostic efficiency was improved when combined with synovial fluid white blood cell count and percentage of polymorphonuclear neutrophils. CONCLUSIONS: Synovial fluid S100A8, S100A9, and HNP1-3 have satisfactory diagnostic efficiency for the diagnosis of PJI, which will help clinicians to accurately diagnose PJI. |
format | Online Article Text |
id | pubmed-10578642 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-105786422023-10-17 Diagnostic Value of Synovial Fluid Biomarkers for Periprosthetic Joint Infection: A Prospective, Double-blind Trial Xu, Ying Ma, Xueting Guo, Haoran Tang, Hairong Liu, Jiayu Wang, Chengbin Wang, Chi Med Sci Monit Lab/In Vitro Research BACKGROUND: This prospective, double-blind study investigated the clinical diagnostic value of synovial fluid S100 calcium-binding protein A8 (S100A8) and S100 calcium-binding protein A9 (S100A9) in periprosthetic joint infection (PJI) and investigated the subtypes of α-defensin that have diagnostic value for PJI. MATERIAL/METHODS: Synovial fluid samples were collected from 82 patients with suspected PJI after total joint arthroplasty. Patients were divided into a PJI group (n=39) and non-PJI group (n=43). Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was used to determine S100A8, S100A9, α-defensin, and internal reference standards in synovial fluid. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of S100A8, S100A9, and α-defensin for PJI, as well as the diagnostic value in combination with common biomarkers of infection. RESULTS: S100A8, 3 variants of S100A9, and 3 α-defensins (human neutrophil peptides [HNP]1–3) in synovial fluid were significantly higher in the PJI group than in the non-PJI group (P<0.001). The sensitivity, specificity, and the area under ROC curve (AUC) for diagnosing PJI were 97.4%, 86.0%, and 0.964 (95% CI: 0.929–0.998), respectively, for synovial fluid S100A8; 87.2%, 88.4% and 0.902 (95% CI: 0.823–0.980), respectively, for S100A9; and 89.7%, 83.7%, and 0.933 (95% CI: 0.884–0.982), respectively, for HNP1-3. The diagnostic efficiency was improved when combined with synovial fluid white blood cell count and percentage of polymorphonuclear neutrophils. CONCLUSIONS: Synovial fluid S100A8, S100A9, and HNP1-3 have satisfactory diagnostic efficiency for the diagnosis of PJI, which will help clinicians to accurately diagnose PJI. International Scientific Literature, Inc. 2023-10-10 /pmc/articles/PMC10578642/ /pubmed/37814443 http://dx.doi.org/10.12659/MSM.940842 Text en © Med Sci Monit, 2023 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) ) |
spellingShingle | Lab/In Vitro Research Xu, Ying Ma, Xueting Guo, Haoran Tang, Hairong Liu, Jiayu Wang, Chengbin Wang, Chi Diagnostic Value of Synovial Fluid Biomarkers for Periprosthetic Joint Infection: A Prospective, Double-blind Trial |
title | Diagnostic Value of Synovial Fluid Biomarkers for Periprosthetic Joint Infection: A Prospective, Double-blind Trial |
title_full | Diagnostic Value of Synovial Fluid Biomarkers for Periprosthetic Joint Infection: A Prospective, Double-blind Trial |
title_fullStr | Diagnostic Value of Synovial Fluid Biomarkers for Periprosthetic Joint Infection: A Prospective, Double-blind Trial |
title_full_unstemmed | Diagnostic Value of Synovial Fluid Biomarkers for Periprosthetic Joint Infection: A Prospective, Double-blind Trial |
title_short | Diagnostic Value of Synovial Fluid Biomarkers for Periprosthetic Joint Infection: A Prospective, Double-blind Trial |
title_sort | diagnostic value of synovial fluid biomarkers for periprosthetic joint infection: a prospective, double-blind trial |
topic | Lab/In Vitro Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578642/ https://www.ncbi.nlm.nih.gov/pubmed/37814443 http://dx.doi.org/10.12659/MSM.940842 |
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