Soluble triggering receptor expressed on myeloid cells: a marker for diagnosis of spontaneous bacterial peritonitis

Abstract

Background Spontaneous bacterial peritonitis (SBP) affects patients with liver cirrhosis. Many studies investigated Triggering receptor expressed on myeloid cells-1 (TREM-1) for diagnosis of bacterial infections. Aim To assess the value of serum and ascitic fluid (sTREM-1) for the detection of SBP among cirrhotic patients with ascites. Patients and method sTREM-1 level was measured in the serum and ascitic fluid of 25 ascitic patients with SBP (group 1) who were compared with 20 ascitic patients without SBP (group 2). Results STREM-1 in ascitic fluid and in serum, were significantly higher in group 1 than in group 2 (P value <0.001 and P value <0.001), respectively. STREM-1 in ascitic fluid can significantly predict SBP at cut-off greater than 123.8 pg/ml with 80% sensitivity, 70% specificity. STREM-1 in serum can significantly predict SBP at cut-off greater than 121.7 pg/ml with 68% sensitivity, 65% specificity. The combination of sTREM-1 in ascitic fluid and sTREM-1 in serum using receiver operating characteristic (ROC) curve analysis for SBP detection was calculated as (P<0.001 and area under the curve = 0.894) with 80% sensitivity, 75% specificity. The combination of sTREM-1 in ascitic fluid and serum did not differ significantly as regards area under the curve when compared with sTREM-1 in ascitic fluid alone (P=0.110). Conclusion sTREM-1 in serum and ascitic fluid may be considered as markers to identify SBP. Combined sTREM-1 in ascitic fluid and serum had no additional benefit.