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Meta-Analysis
. 2023 Jul;182(7):3033-3044.
doi: 10.1007/s00431-023-04978-2. Epub 2023 May 6.

Leucine-Rich Alpha-2-Glycoprotein as a non-invasive biomarker for pediatric acute appendicitis: a systematic review and meta-analysis

Javier Arredondo Montero  1   2 , Blanca Paola Pérez Riveros  3 , Oscar Emilio Bueso Asfura  3 , María Rico Jiménez  3 , Natalia López-Andrés  4 , Nerea Martín-Calvo  3   5   6
Affiliations
Meta-Analysis

Leucine-Rich Alpha-2-Glycoprotein as a non-invasive biomarker for pediatric acute appendicitis: a systematic review and meta-analysis

Javier Arredondo Montero et al. Eur J Pediatr. 2023 Jul.

Erratum in

Abstract

The aim of this study was to analyze the diagnostic performance of Leucine-Rich Alpha-2-Glycoprotein (LRG1) in pediatric acute appendicitis (PAA). We conducted a systematic review of the literature in the main databases of medical bibliography. Two independent reviewers selected the articles and extracted relevant data. Methodological quality was assessed using the QUADAS2 index. A synthesis of the results, standardization of the metrics and 4 random-effect meta-analyses were performed. Eight studies with data from 712 participants (305 patients with confirmed diagnosis of PAA and 407 controls) were included in this review. The random-effect meta-analysis of serum LRG1 (PAA vs control) resulted in a significant mean difference (95% CI) of 46.76 μg/mL (29.26-64.26). The random-effect meta-analysis for unadjusted urinary LRG1 (PAA vs control) resulted in a significant mean difference (95% CI) of 0.61 μg/mL (0.30-0.93). The random-effect meta-analysis (PAA vs control) for urinary LRG1 adjusted for urinary creatinine resulted in a significant mean difference (95% CI) of 0.89 g/mol (0.11-1.66). Conlusion: Urinary LRG1 emerges as a potential non-invasive biomarker for the diagnosis of PAA. On the other hand, due to the high between-study heterogeneity, the results on serum LRG1 should be interpreted with caution. The only study that analyzed salivary LRG1 showed promising results. Further prospective studies are needed to confirm these findings. What is Known: • Pediatric acute appendicitis continues to be a pathology with a high rate of diagnostic error. • Invasive tests, although useful, are a source of stress for patients and their parents. What is New: • LRG1 emerges as a promising urinary and salivary biomarker for the noninvasive diagnosis of pediatric acute appendicitis.

Keywords: Acute appendicitis; Children; LRG1; Leucine-Rich Alpha-2-Glycoprotein; Meta-analysis; Pediatric; Sensitivity; Specificity; Systematic review.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of the search and selection process
Fig. 2
Fig. 2
Graphical representation of the quality assessment of the diagnostic accuracy studies included in the review (QUADAS2)
Fig. 3
Fig. 3
A Forest plot of the random-effects meta-analysis performed for serum LRG1 (PAA group vs. Control group). B Forest plot of the random-effects meta-analysis performed for unadjusted urinary LRG1 (PAA group vs Control group). C Forest plot of the random-effects meta-analysis performed for adjusted-for-creatinine urinary LRG1 (PAA group vs Control group). D Forest plot of the random-effects meta-analysis performed for adjusted-for-creatinine urinary LRG1 (PAA group vs Control group) excluding Mahalik et al
See this image and copyright information in PMC

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