Case Control Study
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World J Gastrointest Surg. Jul 27, 2024; 16(7): 2003-2011
Published online Jul 27, 2024. doi: 10.4240/wjgs.v16.i7.2003
Diagnostic significance of serum levels of serum amyloid A, procalcitonin, and high-mobility group box 1 in identifying necrotising enterocolitis in newborns
Li-Ming Guo, Zhi-Hui Jiang, Hong-Zhen Liu, Lei Zhang
Li-Ming Guo, Zhi-Hui Jiang, Department of General Surgery, Qingdao Women and Children’s Hospital, Qingdao 266000, Shandong Province, China
Hong-Zhen Liu, Department of Pediatric Surgery, Children's Hospital Affiliated to Shandong University, Jinan 250022, Shandong Province, China
Hong-Zhen Liu, Department of Pediatric Surgery, Jinan Children's Hospital, Jinan 250022, Shandong Province, China
Lei Zhang, Department of Pediatric Surgery, Qilu Hospital of Shandong University (Qingdao), Qingdao 260010, Shandong Province, China
Co-first authors: Li-Ming Guo and Zhi-Hui Jiang.
Author contributions: Guo LM and Jiang ZH are co-first authors and contributed equally to this work, including design of the study, acquiring and analyzing data from experiments, and writing of the manuscript. Guo LM, Jiang ZH, and Liu HZ designed the experiments and conducted clinical data collection; Guo LM, Jiang ZH, and Zhang L performed postoperative follow-up and recorded the data, conducted the collation and statistical analysis, and wrote the original manuscript and revised the paper; all authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Qingdao Women and Children’s Hospital.
Informed consent statement: Written informed consent was obtained from the parents or guardians of all children.
Conflict-of-interest statement: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Ming Guo, MM, Department of General Surgery, Qingdao Women and Children’s Hospital, No. 6 Tongfu Road, Shibei District, Qingdao 266000, Shandong Province, China. guolimingqdfe@163.com
Received: March 5, 2024
Revised: May 6, 2024
Accepted: May 30, 2024
Published online: July 27, 2024
Processing time: 139 Days and 8.1 Hours
Abstract
BACKGROUND

Necrotising enterocolitis (NEC) is a critical gastrointestinal emergency affecting premature and low-birth-weight neonates. Serum amyloid A (SAA), procalcitonin (PCT), and high-mobility group box 1 (HMGB1) have emerged as potential biomarkers for NEC due to their roles in inflammatory response, tissue damage, and immune regulation.

AIM

To evaluate the diagnostic value of SAA, PCT, and HMGB1 in the context of NEC in newborns.

METHODS

The study retrospectively analysed the clinical data of 48 newborns diagnosed with NEC and 50 healthy newborns admitted to the hospital. Clinical, radiological, and laboratory findings, including serum SAA, PCT, and HMGB1 Levels, were collected, and specific detection methods were used. The diagnostic value of the biomarkers was evaluated through statistical analysis, which was performed using chi-square test, t-test, correlation analysis, and receiver operating characteristic (ROC) analysis.

RESULTS

The study demonstrated significantly elevated levels of serum SAA, PCT, and HMGB1 Levels in newborns diagnosed with NEC compared with healthy controls. The correlation analysis indicated strong positive correlations among serum SAA, PCT, and HMGB1 Levels and the presence of NEC. ROC analysis revealed promising sensitivity and specificity for serum SAA, PCT, and HMGB1 Levels as potential diagnostic markers. The combined model of the three biomarkers demonstrating an extremely high area under the curve (0.908).

CONCLUSION

The diagnostic value of serum SAA, PCT, and HMGB1 Levels in NEC was highlighted. These biomarkers potentially improve the early detection, risk stratification, and clinical management of critical conditions. The findings suggest that these biomarkers may aid in timely intervention and the enhancement of outcomes for neonates affected by NEC.

Keywords: Serum amyloid A; Procalcitonin; High-mobility group box 1; Necrotising enterocolitis in newborns; Serum biomarkers

Core Tip: This study presents a retrospective analysis of the diagnostic significance of serum amyloid A (SAA), procalcitonin (PCT), and high-mobility group box 1 (HMGB1) as potential biomarkers for necrotising enterocolitis (NEC) in newborns. The findings demonstrate significantly elevated levels of these biomarkers in newborns diagnosed with NEC compared to healthy controls. Furthermore, the study reveals strong positive correlations between serum SAA, PCT, and HMGB1 levels, and the presence of NEC, indicating the potential utility of these markers for early detection and accurate diagnosis of NEC. Combining these biomarkers provides a high area under the curve, suggesting their synergistic diagnostic potential.