Serum Globulin and Albumin to Globulin Ratio as Potential Diagnostic Biomarkers for Periprosthetic Joint Infection: A Retrospective Review

Abstract Background: Periprosthetic joint infection (PJI) has been increasingly documented; however, its preoperative accurate diagnosis remains challenging. Furthermore, there is a dire need to identify appropriate and effective biomarkers. We aimed to evaluate the relationship between globulin, albumin to globulin (A/G) ratio, and development of PJI in patients undergoing revision total joint arthroplasty (TJA).Methods: A retrospective study was conducted on patients who had undergone revision TJA between 2011 and 2018 (89 with aseptic mechanic failure and 38 with PJI). The serum proteins were explored using univariate analysis followed by multivariate logistic regression. The diagnostic performance of these proteins was assessed by the receiver operating characteristic (ROC) curve.Results: Higher globulin levels (odds ratio [OR], 1.239; P<0.001) and lower A/G ratio (OR, 0.007; P<0.001) were strongly associated with the risk of PJI. ROC curve analysis demonstrated reasonable diagnostic performance for globulin (area under the curve [AUC], 0.77; sensitivity, 78.95%; and specificity, 69.66%) and A/G ratio (AUC, 0.779; sensitivity, 65.79%; and specificity, 78.65%).Conclusions: Both globulin and A/G ratio were associated with PJI and may serve as potential adjuvant biomarkers in the diagnosis of PJI.

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Serum globulin and albumin to globulin ratio as potential diagnostic biomarkers for periprosthetic joint infection: a retrospective review

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01959-1 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Yongyu Ye ◽

Weishen Chen ◽

Minghui Gu ◽

Guoyan Xian ◽

Baiqi Pan ◽

...

Keyword(s):

Roc Curve ◽

Periprosthetic Joint Infection ◽

Diagnostic Performance ◽

Serum Proteins ◽

Joint Infection ◽

Univariate Analysis ◽

Area Under The Curve ◽

Roc Curve Analysis ◽

Serum Globulin ◽

G Ratio

Abstract Background Periprosthetic joint infection (PJI) has been increasingly documented; however, its preoperative accurate diagnosis remains challenging. Furthermore, there is a dire need to identify appropriate and effective biomarkers. We aimed to evaluate the relationship between globulin, albumin to globulin (A/G) ratio, and development of PJI in patients undergoing revision total joint arthroplasty (TJA). Methods A retrospective study was conducted on patients who had undergone revision TJA between 2011 and 2018 (89 with aseptic mechanic failure and 38 with PJI). The serum proteins were explored using univariate analysis followed by multivariate logistic regression. The diagnostic performance of these proteins was assessed by the receiver operating characteristic (ROC) curve. Results Higher globulin levels (odds ratio [OR], 1.239; P < 0.001) and lower A/G ratio (OR, 0.007; P < 0.001) were strongly associated with the risk of PJI. ROC curve analysis demonstrated reasonable diagnostic performance for globulin (area under the curve [AUC], 0.77; sensitivity, 78.95%; and specificity, 69.66%) and A/G ratio (AUC, 0.779; sensitivity, 65.79%; and specificity, 78.65%). Conclusions Both globulin and A/G ratio were associated with PJI and may serve as potential adjuvant biomarkers in the diagnosis of PJI.

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Serum Globulin and Albumin to Globulin Ratio as Potential Diagnostic Biomarkers for Periprosthetic Joint Infection: A Retrospective Review

10.21203/rs.3.rs-29096/v1 ◽

2020 ◽

Author(s):

Yongyu Ye ◽

Weishen Chen ◽

Minghui Gu ◽

Guoyan Xian ◽

Baiqi Pan ◽

...

Keyword(s):

Roc Curve ◽

Periprosthetic Joint Infection ◽

Diagnostic Performance ◽

Serum Proteins ◽

Joint Infection ◽

Univariate Analysis ◽

Area Under The Curve ◽

Roc Curve Analysis ◽

Serum Globulin ◽

G Ratio

Abstract Background: Periprosthetic joint infection (PJI) has been increasingly documented; however, its preoperative accurate diagnosis remains challenging. Furthermore, there is a dire need to identify appropriate and effective biomarkers. We aimed to evaluate the relationship between globulin, albumin to globulin (A/G) ratio, and development of PJI in patients undergoing revision total joint arthroplasty (TJA). Methods: A retrospective study was conducted on patients who had undergone revision TJA between 2011 and 2018 (89 with aseptic mechanic failure and 38 with PJI). The serum proteins were explored using univariate analysis followed by multivariate logistic regression. The diagnostic performance of these proteins was assessed by the receiver operating characteristic (ROC) curve. Results: Higher globulin levels (odds ratio [OR], 1.239; P<0.001) and lower A/G ratio (OR, 0.007; P<0.001) were strongly associated with the risk of PJI. ROC curve analysis demonstrated reasonable diagnostic performance for globulin (area under the curve [AUC], 0.77; sensitivity, 78.95%; and specificity, 69.66%) and A/G ratio (AUC, 0.779; sensitivity, 65.79%; and specificity, 78.65%). Conclusions: Both globulin and A/G ratio were associated with PJI and may serve as potential adjuvant biomarkers in the diagnosis of PJI.

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Neutrophil-Lymphocyte Ratio as A Complementary Biomarker of Periprosthetic Joint Infection: A Retrospective Review

10.21203/rs.3.rs-26625/v1 ◽

2020 ◽

Author(s):

Yongyu Ye ◽

Minghui Gu ◽

Weishen Chen ◽

Guoyan Xian ◽

Linli Zheng ◽

...

Keyword(s):

Roc Curve ◽

Periprosthetic Joint Infection ◽

Diagnostic Performance ◽

Joint Infection ◽

Revision Arthroplasty ◽

Diagnostic Odds Ratio ◽

Bivariate Analysis ◽

Roc Curve Analysis ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

Abstract Background: Diagnosing a periprosthetic joint infection (PJI) is challenging. No single biomarker can accurately recognize PJI preoperatively in a timely manner. Therefore, the aim of the present study was to investigate the usefulness of the neutrophil-lymphocyte ratio (NLR) in aiding the diagnosis of PJI.Methods: We retrospectively evaluated the medical records of 109 patients who had undergone revision arthroplasty (77 with aseptic mechanic failure and 32 with PJI) from July 2011 to November 2018. Bivariate analysis followed by multivariate logistic regression was applied to compare NLR between two groups. The receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of NLR alone and in combination with C-reactive protein (CRP) and the erythrocyte sedimentation ratio (ESR).Results: NLR was significantly higher in patients with PJI than in patients of the aseptic revision group (3.12 ± 2.45 vs. 2.10 ± 1.03, p < 0.05). ROC curve analysis revealed that NLR had a sensitivity of 56.25% and a specificity of 80.52% with an optimal threshold of 2.52. The diagnostic performance of NLR alone was inferior to that of CRP and ESR as demonstrated by the area under curve, sensitivity, and diagnostic odds ratio. When used in combination with CRP, the diagnostic performance was nearly equal to the combined performance of CRP and ESR or that of all three biomarkers (p > 0.05).Conclusions: NLR is associated with PJI and could be regarded as a complementary marker, which in combination with CRP could improve the diagnostic performance for PJI.

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Evaluation of serum AFP and DCP levels in the diagnosis of early-stage HBV-related HCC under different backgrounds

Journal of International Medical Research ◽

10.1177/0300060520969087 ◽

2020 ◽

Vol 48 (10) ◽

pp. 030006052096908

Author(s):

Ting Song ◽

Lili Wang ◽

Ruopei Xin ◽

Liping Zhang ◽

Yun Tian

Keyword(s):

Roc Curve ◽

Diagnostic Performance ◽

Operating Characteristic ◽

Early Stage ◽

Area Under The Curve ◽

Curve Analysis ◽

Roc Curve Analysis ◽

Chronic Hbv Infection ◽

B Virus ◽

Chronic Hbv

Objective This study compared the diagnostic performance of alpha-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP) in early-stage hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) under different backgrounds. Methods Patients were enrolled and divided in four groups: chronic HBV infection (CHB), liver cirrhosis (LC), early-stage CHB-HCC, and early-stage LC-HCC. Serum AFP and DCP levels were measured. Receiver-operating characteristic (ROC) curve and area under the curve (AUC) analyses were applied to compare the diagnostic performance of DCP and AFP for HCC. Results In total, 200 patients were enrolled, including 48, 64, 33, and 55 patients with CHB, LC, CHB-HCC, and LC-HCC, respectively. ROC curve analysis revealed that the AUCs of AFP, DCP, and their combination in differentiating early-stage LC-HCC from LC were 0.776, 0.758, and 0.786, respectively. The values of these markers in discriminating early-stage CHB-HCC from CHB were 0.828, 0.731, and 0.862, respectively. Conclusions DCP was inferior to AFP in differentiating early-stage CHB-HCC from CHB. However, AFP and DCP displayed similar performance in distinguishing early-stage LC-HCC and LC.

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Gestational Age as a Predictor of Pregnancy Outcome After Repeat Cerclage

10.21203/rs.3.rs-330034/v1 ◽

2021 ◽

Author(s):

Benshuo Cai ◽

Xinni Na

Keyword(s):

Survival Rate ◽

Pregnancy Outcome ◽

Gestational Age ◽

Roc Curve ◽

Univariate Analysis ◽

Area Under The Curve ◽

Roc Curve Analysis ◽

Kaplan Meier ◽

Significant Difference ◽

The Mean

Abstract Background: The role of repeat cerclage (RC) as a remedy for patients with prolapsed membranes after prior cerclage remains controversial. We aimed to investigate whether gestational age (GA) could be used as a valuable factor for predicting pregnancy outcome following RC in women with prolapsed membranes after prior cerclage. Methods: We retrospectively investigated the clinical data of 29 patients who underwent RC resulting from prolapsed membrane after prior cerclage. Receiving operating characteristic (ROC) curve analysis and univariate analysis were performed to determine predictive factors. Patients were divided into two groups according to GA at RC, GA<24.2 weeks and GA≥24.2 weeks. Pregnancy outcomes were compared between groups.Results: The mean GA at prior cerclage was 16.5 weeks; mean GA at RC was 23.6 weeks. The mean GA at delivery was 27.8 weeks with a 69.0% neonatal survival rate. ROC curve and univariate analysis demonstrated that GA at RC was significantly predictive for neonatal survival (area under the curve: 0.928; p=0.000). Using a GA cut-off of ≥24.2 weeks at RC, the sensitivity and specificity of predicting neonatal survival were 93.75% and 61.54%, respectively. There was a significant difference in neonatal survival rate between the GA <24.2 weeks group and GA ≥24.2 weeks group (38.5% vs. 93.8%, p=0.003). Kaplan–Meier survival curves showed a lower incidence of neonatal death in the GA ≥24.2 weeks group (6.3%) compared with GA <24.2 weeks group (61.5%, p=0.023).Conclusions: GA could be a valuable factor for predicting pregnancy outcome post-RC in women with prolapsed membrane after prior cerclage.

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Limited value of serum neutrophil-to-lymphocyte ratio in the diagnosis of chronic periprosthetic joint infection

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-021-00599-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yongyu Ye ◽

Weishen Chen ◽

Minghui Gu ◽

Qiaoli Liu ◽

Guoyan Xian ◽

...

Keyword(s):

Roc Curve ◽

Periprosthetic Joint Infection ◽

Joint Infection ◽

Univariate Analysis ◽

Revision Arthroplasty ◽

Diagnostic Value ◽

Neutrophil To Lymphocyte Ratio ◽

Optimal Threshold ◽

Level Of Evidence ◽

Lymphocyte Ratio

Abstract Background Diagnosing chronic periprosthetic joint infection (PJI) is challenging. No single biomarker can accurately recognize PJI preoperatively in a timely manner. Therefore, the aim of the present study was to investigate the usefulness of the serum neutrophil-to-lymphocyte ratio (NLR) in aiding the diagnosis of chronic PJI. Materials and methods We retrospectively evaluated the medical records of 158 patients who had undergone revision arthroplasty (104 with aseptic mechanic failure and 54 with chronic PJI) from July 2011 to July 2020. Univariate analysis followed by multivariate logistic regression was applied to compare NLR, C-reactive protein (CRP), and erythrocyte sedimentation ratio (ESR) between the two groups. The receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of NLR alone and in combination with CRP and ESR. Results NLR, CRP, and ESR were significantly higher in patients with chronic PJI than in the aseptic revision group (p < 0.05). ROC curve analysis revealed that NLR had a sensitivity of 57.41% and a specificity of 77.88% with an optimal threshold of 2.56. The optimal threshold for CRP and ESR was 7.00 mg/L (sensitivity 62.50% and specificity 83.12%) and 43 mm/h (sensitivity 59.38% and specificity 80.52%), respectively. The combined diagnostic value of NLR with CRP and ESR was shown to have no additional diagnostic value in predicting chronic PJI. Conclusion Compared with traditional inflammatory biomarkers (ESR and CRP), the value of serum NLR alone or combined with CRP and ESR for diagnosing chronic PJI is limited. Level of evidence Level 3.

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Enlarged Basal Ganglia Perivascular Spaces are Associated with Pulsatile Components of Blood Pressure

European Neurology ◽

10.1159/000486308 ◽

2018 ◽

Vol 79 (1-2) ◽

pp. 86-89 ◽

Cited By ~ 3

Author(s):

Oscar H. Del Brutto ◽

Robertino M. Mera ◽

Keyword(s):

Blood Pressure ◽

Basal Ganglia ◽

Roc Curve ◽

Diastolic Pressure ◽

Univariate Analysis ◽

Systolic Pressure ◽

Area Under The Curve ◽

Curve Analysis ◽

Perivascular Spaces ◽

Roc Curve Analysis

Background/Aims: Pathogenetic mechanisms involved in enlargement of basal ganglia perivascular spaces (BG-PVSs) are controversial. Here, we assessed whether pulsatile or steady components of blood pressure (BP) are associated with enlarged BG-PVS. Methods: We evaluated the association between BG-PVS and pulsatile and steady components of BP in Atahualpa residents aged ≥60 years, by the use of regression models and receiver operator characteristics (ROC) curve analysis, after taking into account the effect of demographics, cardiovascular risk factors, and other signatures of cerebral small vessel disease (SVD). Results: Of 437 candidates, 363 (83%) were included. MRI showed >10 enlarged BG-PVS in 103 (28%) subjects. In univariate analysis, the association between enlarged BG-PVS and systolic pressure (SP) and pulse pressure (PP) were highly significant, while the association with diastolic pressure (DP) was not. ROC curve analysis showed a higher area under the curve for PP than for DP (p < 0.05). The area under the curve for SP was also higher than that of DP, but not significantly better due to overlapping 95% CI. Conclusion: Enlarged BG-PVS are associated with pulsatile components of BP, although some of the effect is taken away by the strong interaction between BG-PVS and other signatures of SVD.

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Predictive CT features for the diagnosis of primary pulmonary mucoepidermoid carcinoma: comparison with squamous cell carcinomas and adenocarcinomas

Cancer Imaging ◽

10.1186/s40644-020-00375-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiaohua Ban ◽

Xinping Shen ◽

Huijun Hu ◽

Rong Zhang ◽

Chuanmiao Xie ◽

...

Keyword(s):

Logistic Regression ◽

Roc Curve ◽

Multinomial Logistic Regression ◽

Univariate Analysis ◽

Ct Imaging ◽

Squamous Cell Carcinomas ◽

Curve Analysis ◽

Imaging Features ◽

Roc Curve Analysis ◽

Ct Features

Abstract Background To determine the predictive CT imaging features for diagnosis in patients with primary pulmonary mucoepidermoid carcinomas (PMECs). Materials and methods CT imaging features of 37 patients with primary PMECs, 76 with squamous cell carcinomas (SCCs) and 78 with adenocarcinomas were retrospectively reviewed. The difference of CT features among the PMECs, SCCs and adenocarcinomas was analyzed using univariate analysis, followed by multinomial logistic regression and receiver operating characteristic (ROC) curve analysis. Results CT imaging features including tumor size, location, margin, shape, necrosis and degree of enhancement were significant different among the PMECs, SCCs and adenocarcinomas, as determined by univariate analysis (P < 0.05). Only lesion location, shape, margin and degree of enhancement remained independent factors in multinomial logistic regression analysis. ROC curve analysis showed that the area under curve of the obtained multinomial logistic regression model was 0.805 (95%CI: 0.704–0.906). Conclusion The prediction model derived from location, margin, shape and degree of enhancement can be used for preoperative diagnosis of PMECs.

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Erythrocyte and Reticulocyte Indices on the LH 750 as Potential Markers of Functional Iron Deficiency

Anemia ◽

10.1155/2010/625919 ◽

2010 ◽

Vol 2010 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Eloísa Urrechaga ◽

Luís Borque ◽

Jesús F. Escanero

Keyword(s):

Iron Deficiency ◽

Roc Curve ◽

Diagnostic Performance ◽

Iron Status ◽

Curve Analysis ◽

Size Factor ◽

Hemoglobin Content ◽

Roc Curve Analysis ◽

Functional Iron Deficiency ◽

Reticulocyte Hemoglobin Content

Reticulocyte hemoglobin content (CHr) and percentage of hypochromic cells (%Hypo) are restricted to the Siemens analysers. The aims of the study were to investigate the correlation of Red cells size factor (RSf) and low Hemoglobin density (LHD%), reported by Beckman-Coulter analysers, with CHr and %Hypo in the assessment of iron status in the presence of inflammation. 381 samples were run on both LH 750 (Beckman-Coulter) and Advia 2120 (Siemens) analysers. Correlation between parameters were calculated and the diagnostic performance of the new parameters was assessed.Results. Correlation between RSf and CHr, . ROC curve analysis for RSf in the diagnosis of iron restricted erythropoiesis defined as CH pg: AUC 0.983; Cutoff 91.1%; Sensitivity 98.8%; Specificity 89.6% Correlation between LHD% and %Hypo, . ROC curve analysis for LHD% in the diagnosis of iron deficiency defined by %Hypo %: AUC 0.954; Cut off 6.0%; Sensitivity 96.6%; Specificity 83.2%Conclusions. RSf and LHD% could be reliable parameters for the study of iron metabolism status.

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Utility of N-Terminal Pro-B-Type Natriuretic Peptide to Differentiate Cardiac Diseases from Noncardiac Diseases in Young Pediatric Patients

Clinical Chemistry ◽

10.1373/clinchem.2005.060608 ◽

2006 ◽

Vol 52 (7) ◽

pp. 1415-1419 ◽

Cited By ~ 23

Author(s):

Angelika Hammerer-Lercher ◽

Ralf Geiger ◽

Johannes Mair ◽

Christoph Url ◽

Gerald Tulzer ◽

...

Keyword(s):

Natriuretic Peptide ◽

Diagnostic Performance ◽

Pediatric Patients ◽

Clinical Symptoms ◽

Linear Regression Analysis ◽

Area Under The Curve ◽

Cardiac Diseases ◽

Healthy Children ◽

Roc Curve Analysis ◽

Diagnostic Usefulness

Abstract Background: Previous studies comparing children with cardiac disease with children with lung disease or healthy children indicated that natriuretic peptides are promising markers in pediatric patients. The aim of this study was to further clarify the diagnostic usefulness of N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurements in a less preselected population of children younger than 3 years, a population in which clinical symptoms are frequently unspecific. Methods: NT-proBNP concentrations (Roche Diagnostics) were measured in sera of 142 pediatric patients (age range, 33–1070 days) presenting at the Gynaecologic and Pediatric Hospital (Linz, Austria) between January 2003 and January 2004. ROC curve analysis for the diagnostic performance of NT-proBNP, the Mann–Whitney U-test for group comparison, and linear regression analysis for influencing factors were performed. Results: NT-proBNP concentrations were significantly increased in infants with cardiac diseases [median (25th–75th percentile), 3681 (1045–13557) ng/L; n = 23] compared with infants with other diseases [241 (116–542) ng/L; n = 119], and ROC analysis revealed good performance for NT-proBNP in differentiating between infants with and without cardiac diseases [mean area under the curve (AUC) with 95% confidence interval (CI), 0.87 (0.76–0.94)]. A subgroup analysis of exactly age- and sex-matched infants was performed, which revealed results comparable to those for the whole study population [mean (95% CI) AUC, 0.84 (0.68–0.93)]. Conclusion: In a heterogeneous group of pediatric patients <3 years of age, NT-proBNP showed good diagnostic performance to distinguish between cardiac diseases and various noncardiac diseases.

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