measurement of serum tnf-α as an accurate marker in diagnosing extrahepatic biliary atresia
نویسندگان
چکیده
background : most diagnostic tests for biliary atresia (ba) are invasive. this study evaluates the sensitivity and specificity of serum tumor necrosis factor-α (tnf-α) for diagnosing extra hepatic biliary duct atresia (ehba) in infants. materials and methods : infants with cholestasis who were admitted to children′s medical center hospital were evaluated. a total of 50 infants (20 with ehba and 30 non-ehba) were included in this study. we evaluated the definite cause of cholestasis. intra-operative cholangiography and, if possible, kasai portoenterostomy were performed in infants with high suspicion for ehba. upon admission and prior to surgical intervention, infants had their serum tnf-α levels measured by elisa. we compared the mean tnf-α level between the two groups, in addition to the sensitivity and specificity of serum tnf-α for diagnosis of ehba . results : this study enrolled 28 (56%) male and 22 (44%) female infants. infants' mean age was 2.87 months in the ehba group and 2.6 months in the non-ehba group. sensitivity of serum tnf was 60% and its specificity was 76.66% for predicting ehba. the positive predictive value was calculated as 63.1%, the negative predictive value was 74.1%, and accuracy was 70%. there was a significantly higher mean serum tnf-α level in the ehba group (220 pg/ml) compared to the non-ehba group (79.8 pg/ml; p =0.023). serum tnf-α cut off point for determining ehba from non-ehba was calculated as 80 pg/ml. mean serum tnf-α in males (171.28 pg/ml) was more than females (90.80 pg/ml). conclusion : there was a significantly higher mean serum tnf-α level in the ehba group than the non-ehba group. serum tnf-α could be a proper test that has comparatively good sensitivity, specificity, positive predictive value and negative predictive value for predicting ehba.
منابع مشابه
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گوارشجلد ۱۹، شماره ۲، صفحات ۱۴۳-۰
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