Diagnostic Potential of Biochemical Markers in Acute Mesenteric Ischemia: A Modern Approach

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Abstract

BACKGROUND: Early and specific diagnosis of urgent abdominal conditions is prioritized in contemporary surgical practice because it facilitates minimally invasive interventions and improves postoperative outcomes.

AIM: To assess the diagnostic value, specificity, and sensitivity of selected biochemical markers and establish reference values for identifying acute mesenteric ischemia.

MATERIAL AND METHODS: The biochemical markers of acute mesenteric ischemia were analyzed in 40 patients admitted at the Surgical Department of Ryazan Regional Clinical Hospital between January and November 2023. Two patient groups were formed: the main group included 24 patients with acute reversible mesenteric ischemia, and the control group comprised 16 patients with atherosclerotic or embolic bowel gangrene. The following candidate markers were evaluated: diamine oxidase, tumor protein p53, and nitric oxide. A prospective study was conducted. Statistical analysis was performed using StatTech 4.2.7. Quantitative variables were assessed for distribution using the Shapiro–Wilk test. The two groups were compared based on quantitative variables using the Mann–Whitney U test. The diagnostic utility of the quantitative indicators of outcome prediction was evaluated using ROC curve analysis. The cut-off quantitative variable value was determined based on the maximum Youden index.

RESULTS: Tumor protein p53 levels ≥40.30 μmol/L, diamine oxidase ≥5.59 μmol/L, and nitric oxide ≥48.13 μmol/L were predictive of acute mesenteric ischemia before the onset of irreversible bowel wall damage. The sensitivity and specificity of tumor protein p53 were 83.3% and 100%, respectively, and 100% and 94.4% for diamine oxidase and 100% and 91.1% for nitric oxide.

CONCLUSION: Diamine oxidase, tumor protein p53, and nitric oxide are good biochemical markers for the early diagnosis of acute mesenteric ischemia.

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About the authors

Fedor D. Kochetkov

Ryazan State Medical University Ryazan; Regional Clinical Hospital

Author for correspondence.
Email: kochetkovf@bk.ru
ORCID iD: 0000-0001-6646-8595
SPIN-code: 9806-5369

Assistant Lecturer, Depart. of Faculty Surgery surgeon, Depart. of Emergency Surgery

Russian Federation, 9 Vysokovoltnaya st, Ryazan, 390026; Ryazan

Igor A. Suchkov

Ryazan State Medical UniversityRyazan

Email: suchkov_med@mail.ru
ORCID iD: 0000-0002-1292-5452
SPIN-code: 6473-8662

MD, Dr. Sci. (Medicine), Professor, Depart. of Cardiovascular, X-ray Endovascular Surgery and Radiology

Russian Federation, 9 Vysokovoltnaya st, Ryazan, 390026

Oleg V. Zaitsev

Ryazan State Medical University Ryazan; Regional Clinical Hospital

Email: ozaitsev@yandex.ru
ORCID iD: 0000-0002-1822-3021
SPIN-code: 4556-7922

MD, Dr. Sci. (Medicine), Professor, Depart. of Hospital Surgery

Russian Federation, 9 Vysokovoltnaya st, Ryazan, 390026; Ryazan

Darya A. Samarina

Ryazan State Medical University

Email: daryhay.foreve@gmail.com
ORCID iD: 0009-0005-1531-6547
SPIN-code: 7210-8326

6th year student, Faculty of Medicine

Russian Federation, 9 Vysokovoltnaya st, Ryazan, 390026

Vasily S. Antonov

Ryazan State Medical University

Email: nazcap88@gmail.com
ORCID iD: 0009-0009-6875-2763

5th year student, Faculty of Medicine

Russian Federation, 9 Vysokovoltnaya st, Ryazan, 390026

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2. Fig. 1. Sensitivity and specificity of the serum diamine oxidase model.

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3. Fig. 2. Sensitivity and specificity of the tumor protein p53 model in patients from the control and main groups.

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