乳酸脱氢酶（LDH）活性与积液中总核细胞计数之比（LDH/TNCC比值）在猫传染性腹膜炎（FIP）诊断中的应用。

Utility of the Ratio between Lactate Dehydrogenase (LDH) Activity and Total Nucleated Cell Counts in Effusions (LDH/TNCC Ratio) for the Diagnosis of Feline Infectious Peritonitis (FIP).

作者信息

Romanelli Pierpaolo, Paltrinieri Saverio, Bonfanti Ugo, Castaman Marco Graziano, Monza Elisa, Bertazzolo Walter

机构信息

MYLAV Veterinary Laboratory La Vallonea, 20017 Passirana di Rho, Italy.

Department of Veterinary Medicine and Animal Sciences, University of Milan, 26900 Lodi, Italy.

出版信息

Animals (Basel). 2022 Aug 31;12(17):2262. doi: 10.3390/ani12172262.

DOI:10.3390/ani12172262

PMID:36077981

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9454717/

Abstract

BACKGROUND

We tested the hypothesis that the ratio between lactate dehydrogenase activity (LDH) and total nucleated cell counts (TNCC) in effusions may be useful to diagnose feline infectious peritonitis (FIP).

METHODS

LDH/TNCC ratio was retrospectively evaluated in 648 effusions grouped based on cytology and physicochemical analysis (step 1), on the probability of FIP estimated by additional tests on fluids (step 2) or on other biological samples (step 3, = 471). Results of different steps were statistically compared. Receiver Operating Characteristic (ROC) curves were designed to assess whether the ratio identify the samples with FIP "probable/almost confirmed". The cut-offs with the highest positive likelihood ratio (LR+) or Youden Index (YI) or with equal sensitivity and specificity were determined.

RESULTS

A high median LDH/TNCC ratio was found in FIP effusions (step1: 2.01) and with probable or almost confirmed FIP (step 2: 1.99; 2.20 respectively; step 3: 1.26; 2.30 respectively). The optimal cut-offs were 7.54 (LR+ 6.58), 0.62 (IY 0.67, sensitivity: 89.1%; specificity 77.7%), 0.72 (sensitivity and specificity: 79.2%) in step 2 and 2.27 (LR+ 10.39), 0.62 (IY 0.65, sensitivity: 82.1%; specificity 83.0%), 0.54 (sensitivity: 82.1%; specificity 81.9%) in step 3.

CONCLUSIONS

a high LDH/TNCC ratio support a FIP diagnosis.

摘要

背景

我们检验了一个假设，即积液中乳酸脱氢酶活性（LDH）与总核细胞计数（TNCC）之比可能有助于诊断猫传染性腹膜炎（FIP）。

方法

回顾性评估了648例积液的LDH/TNCC比值，这些积液根据细胞学和理化分析进行分组（步骤1），根据对液体进行的其他检测估计的FIP可能性进行分组（步骤2）或根据对其他生物样本进行的检测进行分组（步骤3，n = 471）。对不同步骤的结果进行统计学比较。绘制受试者工作特征（ROC）曲线，以评估该比值是否能识别出FIP“可能/几乎确诊”的样本。确定具有最高阳性似然比（LR+）或约登指数（YI）或具有相等敏感性和特异性的临界值。

结果

在FIP积液中发现了较高的LDH/TNCC比值中位数（步骤1：2.01），以及FIP可能或几乎确诊的积液（步骤2：分别为1.99；2.20；步骤3：分别为1.26；2.30）。步骤2中的最佳临界值分别为7.54（LR+ 6.58）、0.62（YI 0.67，敏感性：89.1%；特异性77.7%）、0.72（敏感性和特异性：79.2%），步骤3中的最佳临界值分别为2.27（LR+ 10.39）、0.62（YI 0.65，敏感性：82.1%；特异性83.0%）、0.54（敏感性：82.1%；特异性81.9%）。