Clinical value of urine heparin-binding protein in the diagnosis of urinary tract infection

Abstract

Objective To dectect urine level of heparin-binding protein(HBP) in screening urinary tract infection(UTI). Methods A case-control study was performed. From June 2016 to December 2016, urine levels of HBP were detected by enzyme linked immunosorbent assay in 119 patients with definite UTI, 18 patients with probable UTI, 58 patients with no UTI and 52 normal controls who were enrolled at Fudan University Hua Shan Hospital North. Meanwhile, urine leukocyte esterase test(U-LE) and urine nitrite test(U-NIT) were performed by urine dipstick analyzer. And count of urine WBC (U-WBC) was performed by urine formed elements analyzer. The overall level of each group was compared using Kruskal-Wallis H test. Two independent samples were compared by Mann-Whitney U test. The correlation between U-HBP, U-LE and U-WBC were assessed using Spearman′s rank coefficient. Receiver operating characteristic curves were constructed to illustrate the diagnostic power of U-HBP, U-LE, U-NIT and U-WBC for UTI. Results In definite UTI group, probable UTI group, no UTI group and normal control group, the levels of U-HBP, U-LE, U-NIT and U-WBC were significantly different (H values were 166.73, 126.88, 47.92 and 144.05, respectively, P<0.05). Areas under the receiver-operating characteristics curves (AUC) of U-HBP, U-LE, U-NIT and U-WBC were 0.948, 0.836, 0.671 and 0.897 respectively for the diagnosis of UTI. When a cut-off value of 69.20 ng/ml was used in U-HBP, the sensitivity and specificity for detection of definite UTI were 89.9% (107/119) and 89.1% (114/128), respectively. When U-LE at a cut-off value of 4+ , the sensitivity was 76.5% (91/119) and specificity was 81.3% (104/128). When U-NIT at a cut-off value of 1+ , the sensitivity was 36.1% (43/119) and specificity was 97.7% (125/128). When U-WBC at a cut-off value of 233.6/μl, the sensitivity was 82.4%(98/119) and specificity was 82.8%(106/128). A strong correlation was detected between U-HBP and U-WBC (r=0.896, P<0.05). The correlation between U-HBP and U-LE was also strong (r=0.798, P<0.05). Conclusions Heparin-binding protein in the urine was significantly better in diagnosis of UTI, compared with the other markers. It could probably be acted as an important new biomarker for diagnosis of UTI.(Chin J Lab Med, 2017, 40: 953-958) Key words: Heparin-binding protein; Urine; Urinary tract infection; Urine leukocyte esterase test; Urine nitrite test; Count of urine WBC