title: Correlation of plasma osteopontin and neutrophil gelatinase-associated lipocalin levels with the severity and clinical outcome of pelvic inflammatory disease.
abstract: OBJECTIVE
  To investigate the correlation of two important inflammatory biomarkers, plasma osteopontin and neutrophil gelatinase-associated lipocalin (NGAL), with the severity and outcome of pelvic inflammatory disease (PID).
  
  
  METHODS
  Sixty-one patients with PID, including 25 patients with tubo-ovarian abscess (TOA), were consecutively recruited. Their blood samples were tested for the concentrations of plasma osteopontin and NGAL using enzyme-linked immunosorbent assay. The associations of these biomarkers with TOA, length of hospitalization, and incidence of surgery were also analyzed.
  
  
  RESULTS
  Plasma osteopontin level was significantly increased in PID patients with TOA compared to PID patients without TOA (median 107.77 ng/mL vs. 72.39 ng/mL, p = 0.004). However, there was no significant difference for plasma NGAL. If the cutoff level of plasma osteopontin was set at 81.1 ng/mL, there was a 76.0% sensitivity and a 24.0% false negative rate in predicting TOA in PID patients. Plasma osteopontin significantly correlated with length of hospital stay (r = 0.467, p < 0.001), and this correlation was better than that of NGAL. However, neither biomarker was associated with incidence of surgery.
  
  
  CONCLUSIONS
  Plasma osteopontin has a better correlation with TOA and length of hospitalization compared to NGAL. If plasma osteopontin level falls below 81.1 ng/mL, PID patients will have about a 20% chance of developing TOA. Incorporating plasma osteopontin, but not NGAL, will allow for an adjuvant diagnostic biomarker for TOA and predictor of length of hospital stay.
authors.affiliation: Institute of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; School of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan.
authors.forename: Yi-Torng
authors.initials: YT
authors.lastname: Tee
authors.affiliation: Institute of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; School of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan.
authors.forename: Po-Hui
authors.initials: PH
authors.lastname: Wang
authors.affiliation: Institute of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; Department of Medical Research, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; Department of Clinical Laboratory, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan.
authors.forename: Shun-Fa
authors.initials: SF
authors.lastname: Yang
authors.affiliation: School of Nursing, College of Nursing, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; Institute of Nursing, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan.
authors.forename: Hsiu-Ting
authors.initials: HT
authors.lastname: Tsai
authors.affiliation: School of Nursing, College of Nursing, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; Institute of Nursing, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan.
authors.forename: Shu-Kuei
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Institute of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan. Electronic address: ginhow84921344@yaoo.com.tw.
authors.forename: Jiunn-Liang
authors.initials: JL
authors.lastname: Ko
authors.affiliation: Institute of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; School of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan. Electronic address: ginhow84921344@yaoo.com.tw.
authors.forename: Long-Yau
authors.initials: LY
authors.lastname: Lin
authors.affiliation: Institute of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; School of Medicine, Chung Shan Medical University, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan; Department of Family and Community Medicine, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan. Electronic address: ginhow84921344@yaoo.com.tw.
authors.forename: Shiuan-Chih
authors.initials: SC
authors.lastname: Chen
mesh_terms: D018784:Abdominal Abscess / Q000097:blood* / Q000150:complications / Q000601:surgery; D000209:Acute-Phase Proteins; D000328:Adult; D015415:Biomarkers / Q000097:blood; D005184:Fallopian Tube Diseases / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D007902:Length of Stay; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood*; D008875:Middle Aged; D053495:Osteopontin / Q000097:blood*; D010049:Ovarian Diseases / Q000097:blood* / Q000150:complications; D000292:Pelvic Inflammatory Disease / Q000097:blood* / Q000150:complications / Q000601:surgery; D011237:Predictive Value of Tests; D011518:Proto-Oncogene Proteins / Q000097:blood*; D012720:Severity of Illness Index
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D053495:Osteopontin
keywords: length of hospital stay; neutrophil gelatinase-associated lipocalin; osteopontin; pelvic inflammatory disease; tubo-ovarian abscess