neutrophil counts distinguish between malignancy and arthritis in children with musculoskeletal pain a case–control study嗜中性粒细胞计数区分恶性肿瘤和关节炎患儿肌肉骨骼疼痛病例对照研究.pdfVIP

Agodi et al. BMC Pediatrics 2013, 13:15 /1471-2431/13/15 RESEARCH ARTICLE Open Access Neutrophil counts distinguish between malignancy and arthritis in children with musculoskeletal pain: a case–control study 1 1 2 3 2 3 Antonella Agodi , Martina Barchitta , Cristina Trigilia , Patrizia Barone , Silvia Marino , Rosaria Garozzo , Manuela La Rosa1, Giovanna Russo2 and Andrea Di Cataldo2* Abstract Background: To identify the predictive factors for malignancies using basic clinical and laboratory information in children presenting with musculoskeletal pain and eventually diagnosed with juvenile idiopathic arthritis (JIA) or malignancy. Methods: A retrospective case–control chart review research examining laboratory data from patients referred for musculoskeletal pain in 2001–2010 and diagnosed with malignancy or JIA was performed. The validity of each test for the diagnosis of neoplasia was assessed by calculating the sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and likelihood ratios. Results: A total of 134 patients were enrolled. Statistically significant differences were found in neutrophil count, Hb, LDH, IgA and C4 values, ANA, anti-EA EBV IgG and anti-CMV IgG titres. High LDH value and anti-CMV IgG were the most predictive factors for neoplasia. High specificity factors for neoplasia were abnormal values of neutrophil count, Hb, IgA and C4, and the presence of anti-EA EBV and anti-CMV IgG. High PPV were recorded for abnormal neutrophil count, Hb value and anti-CMV titre. A low NPV was found only for anti-EA EBV and anti-CMV titres. Conclusions: In this setting of patients, minimum changes in neutrophil count, particularly if associated with low