Performance of Synovial Fluid PRTN3 and MNDA for Diagnosing Periprosthetic Joint Infection:Comparison with the Use of α-defensin
Objective To verify the reliability of proteinase 3(PRTN3)and myeloid nuclear differentiation antigen(MNDA)for diagnosing periprosthetic joint infection(PJI)via ELISA,and to compare with traditional biomarkers α-defensin.Methods A total of 65 consecutive specimens from patients with suspected PJI were included in this study.Based on the 2014 Musculoskeletal Infection Society(MSIS)criteria,29 patients were included in the PJI group and 36 in the non-PJI group.Commercial ELISA kits were used to detect the biomarker levels in synovial fluid.The sensitivity and specificity of the biomarkers were analyzed,and receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performance of the investigated biomarkers.Results The PJI group was dominated by staphylococcus,accounting for 31％,and the negative culture patients accounted for 34.5％.PRTN3 had the highest area under the curve at 0.984(95％CI,0.961-1.000),followed by α-defensin and MNDA,with AUC of 0.944(95％CI,0.888-1.000)and 0.849(95％CI,0.755-0.943),respectively.The cutoff value of PRTN3 was 318.000 ng/mL),and its sensitivity and specificity were 0.931 and 0.972,respectively.The cutoff value of α-defensin was 7.150 μg/mL,and its sensitivity and specificity were 0.931 and 0.861,respectively.The cutoff value of MNDA was 4.318 ng/mL,and its sensitivity and specificity were 0.862 and 0.722,respectively.Conclusion Both PRTN3 and MNDA are excellent biomarkers for PJI.The PRTN3 has the best performance even slightly better than that of α-defensin.
NETL
NSTL
万方数据
