Serum Procalcitonin and Lactoferrin in Detection of Acute Appendicitis; a Diagnostic Accuracy Study

Introduction: Finding an accurate diagnostic test can reduce the rate of unnecessary abdominal surgery in cases of suspected acute appendicitis (AA). This study aimed to evaluate the diagnostic value of serum lactoferrin (LF) and procalcitonin (PCT) in detection of patients with acute appendicitis. Methods: In this diagnostic accuracy study, screening performance characteristics of PCT and LF were calculated in patients suspected with acute appendicitis and healthy volunteers as control group. Results: 131 cases participated (61 as case and 70 as control). The mean serum level of LF (0.9 +/- 0.14 vs 0.2 +/- 0.13 mu g/ml; p 0.0001) and PCT (0.15 +/- 0.21 vs 0.11 +/- 0.02 ng/dl; p = 0.02) were significantly higher in patients suspected with AA. The AUC of PCT and LF were 0.46 (95% CI: 0.31-0.61) and 0.61 (95% CI: 0.47 - 0.76), respectively. At a 0.90 mu g/ml cut-off value, LF had 77% (95 % CI: 63 - 91) sensitivity and 43% (95% CI: 31 - 55) specificity. Also, at a 0.11 ng/dl cut-off value, PCT had 41% (95% CI: 26 - 56) sensitivity and 69% (95% CI: 53 - 85) specificity. Conclusion: Based on the main finding of present study, the overall accuracy of serum PCT and LF in detection of patients with acute appendicitis are in poor to failed range and it seems that they could not be considered as good screening tools for this purpose.