Evaluation of CK-MB as a diagnostic biomarker in acute appendicitis

Abstract

Objective: Negative appendectomy (normal histopathology) occurs in 5-42% of patients undergoing surgery with a preliminary diagnosis of acute appendicitis. Although accurate anamnesis and physical examination are an essential component of diagnosis, inexpensive, effective, and easily implemented markers of appendicitis are necessary to reduce morbidity associated with this condition. We investigated the use of common laboratory parameters as markers in the diagnosis of acute appendicitis. Materials-methods: The study followed a case-control design. There were 100 patients in the control group and 100 patients with the acute appendicitis in study group. White blood cell count (WBC), bilirubin, mean platelet volume (MPV), and creatine kinase (CK)/creatine kinase MB (CK-MB) values were compared between the two groups. Results: The mean CK-MB value was 18.0 u/l (27.5-47.8) and 15.0 u/l (10.3-19.0) in study and the control groups, respectively. Using an optimal CK-MB cut-off value of 17.5 u/l in ROC analysis, the diagnostic sensitivity was 81% and the specificity was 70%. The diagnostic value of CK-MB to show acute appendicitis was less than the diagnostic value of WBC, which had sensitivity of 93% and specificity of 73% at 9500 u/l cut-off value. Bilirubin had a sensitivity of 79% and specificity of 40% using a cut-off value of 0.5 mg/dl. There was no significant difference between groups in CK and MPV values (P = 0.803 and P = 0.172, respectively). Conclusion: The aim of this study was to evaluate the diagnostic value of CK-MB in the diagnosis of acute appendicitis. We determined that CK-MB can be a valuable diagnostic parameter when used in conjunction with WBC and bilirubin.