Plasma cytokines can help to identify the development of severe acute pancreatitis on admission

Deng, Lihui; Hu, Cheng; Cai, Wenhao; Chen, Weiwei; Zhang, Xiao‐Xin; Shi, Na; Huang, Wei; Ma, Yun; Jin, Tao; Lin, Ziqi; Jiang, Kun; Guo, Jia; Yang, Xiaonan; Xia, Qing

doi:10.1097/md.0000000000007312

Cited by 20 publications

(25 citation statements)

References 41 publications

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“…These results were consistent with those of previous studies showing that WBC count, NLR, CRP, BUN, and creatinine were associated with the severity of acute pancreatitis. [4510111524] The above serum biomarkers showed a significant difference also in the logistic regression analysis of this study. In contrast, previous studies related to AST and total bilirubin were not found.…”

Section: Discussionsupporting

confidence: 60%

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Predictive values of neutrophil-lymphocyte ratio as an early indicator for severe acute pancreatitis in the emergency department patients

Park

Yoon

et al. 2019

J Lab Physicians

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CONTEXT: Acute pancreatitis is an acute inflammatory disease presenting with a wide range of severity. AIMS: We investigated the predictive values of the neutrophil-lymphocyte ratio (NLR) as an indicator for severe acute pancreatitis in the emergency department patients. SETTINGS AND DESIGN: This retrospective study was conducted on patients with acute pancreatitis who were diagnosed in the emergency department, from January 2008 to December 2017. SUBJECTS AND METHODS: Patients were classified into either mild-to-moderate severe group or severe group according to the Revised Atlanta Classification for Acute Pancreatitis. Clinical features and laboratory blood test parameters were considered as independent variables. STATISTICAL ANALYSIS USED: Independent variables were analyzed using the Chi-square test and Mann–Whitney U-test to determine statistically significant differences between the two groups. Logistic regression analysis and receiver operating characteristic analysis were performed to evaluate the predictive values of significantly different variables. RESULTS: Of the 672 patients, 52 (7.7%) were classified into the severe group. Tachycardia, fever, prevalence of liver cirrhosis and chronic alcoholism, white blood cell count, NLR, C-reactive protein (CRP), blood urea nitrogen (BUN), creatinine, aspartate transaminase, and total bilirubin were significantly higher in the severe group. Among them, NLR (adjusted odds ratio [aOR]: 1.13; 95% confidence interval [CI]: 1.081–1.181), CRP (aOR: 1.011; 95% CI: 1.004–1.017), BUN (aOR: 1.036; 95% CI: 1.004–1.069), and creatinine (aOR: 1.703; 95% CI: 1.008–2.877) were significant in the logistic regression analysis. NLR showed relatively high sensitivity (82.7%) and specificity (70%) and showed the highest area under the curve (0.821). CONCLUSIONS: The increase in NLR was associated with severe acute pancreatitis. NLR is expected to be useful as a prognostic factor in patients with acute pancreatitis who are visiting the emergency department.

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Section: Discussionsupporting

confidence: 60%

“…[11] In addition, there are reports of albumin, total cholesterol, high-density lipoprotein, creatinine, and cytokines being able to predict severe acute pancreatitis. [12131415] However, these serum markers also had their limitations and no definitive consensus as to the prognostic criteria for acute pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

Predictive values of neutrophil-lymphocyte ratio as an early indicator for severe acute pancreatitis in the emergency department patients

Park

Yoon

et al. 2019

J Lab Physicians

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“…The concentration of PTX3 was significantly higher only in patients with severe acute pancreatitis, and it was considered an independent prognostic factor in the course of the disease. The concentration of PTX3 reached a maximum concentration earlier than CRP and reached similar values in the early stage of the disease to the concentration of IL-6 [24]. In our tested group of patients with AP, the concentration of PTX 3 in the first 24 h of the disease was four times higher in mild AP and seven times higher in SAP, in comparison with the control group.…”

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confidence: 62%

Clinical usefulness of pentraxin 3 (PTX3) as a biomarker of acute pancreatitis and pancreatic cancer

Głuszek¹,

Matykiewicz²,

Grabowska³

et al. 2020

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Introduction: Increased concentrations of pentraxin 3 (PTX 3) were diagnosed in acute pancreatitis (AP) and in pancreatic ductal adenocarcinoma (PDAC). Aim of the research: To assess of the clinical usefulness of PTX3 in the early differentiation of AP from PDAC. Material and methods: The test group consisted of 125 patients with AP and 24 people with PDAC, as well as 52 healthy subjects. The following concentrations were tested in plasma: PTX3, C-reactive protein (CRP), interleukin-6 (IL-6), and CA-19.9. Results: The mean PTX3 concentration in the moderately-severe AP (MAP) or severe AP (SAP) equalled 16.53 ng/ml and was significantly higher in comparison with mild AP (9.60 ng/ml; p = 0.0007) and the control group (2.31 ng/ml). In the case of patients with PDAC, the mean concentration of PTX3 was 9.20 ng/ml and was significantly higher than in the control group (2.31 ng/ml); p < 0.0001. A significantly higher average CRP value of 100.37 mg/l and IL-6 91.65 pg/ml was also found in patients with PDAC compared to the control group (p < 0.0001). Tested pro-inflammatory cytokines were significantly higher in patients with MAP or SAP than in those with PDAC (p < 0.05). The ROC curve confirms the clear connection of PTX3 level and PDAC in comparison with the control group (p = 0.0001), relatively low sensitivity, and high specificity. However, the results were not significant enough to allow us to differentiate cancer from AP (p > 0.05). Conclusions: Pentraxin 3 can be a marker in the prediction of the severe course of AP, but its clinical usefulness for the differentiation of PDAC was not confirmed. Streszczenie Wprowadzenie: Podwyższone stężenie pentraksyny 3 (PTX3) stwierdzono zarówno w ostrym zapaleniu trzustki (AP), jak i raku trzustki (PDAC). Cel pracy: Ocena przydatności klinicznej PTX3 we wczesnym różnicowaniu AP i PDAC. Materiał i metody: Zbadano 125 chorych na AP i 24 chorych z potwierdzonym histopatologicznie lub cytologicznie PDAC oraz 52 osoby zdrowe jako grupę kontrolną. Próbkę krwi pobierano w pierwszym dniu hospitalizacji. Oznaczono stężenia w osoczu PTX3, białka C-reaktywnego (CRP), interleukiny (IL-6) i aktywność CA-19.9. Wyniki: Średnie stężenie PTX3 u pacjentów z umiarkowanie ciężkim AP (MAP) i ciężkim AP (SAP) wynosiło 16,53 ±15,73 ng/ml i było istotnie wyższe niż średnie stężenia u pacjentów z łagodnym AP (9,60 ±9,65 ng/ml; p = 0,0007) i z grupy kontrolnej (2,31 ±0,58 ng/ml). Średnie stężenie PTX3 u chorych z PDAC wynosiło 9,20 ng/ml i było znacząco większe niż stężenie w grupie kontrolnej (2,31 ng/ml); p < 0,0001. Stwierdzono również istotnie wyższą średnią wartość CRP 100,37 mg/l i IL-6 91,65 pg/ml u chorych z PDAC w porównaniu z grupą osób zdrowych (p < 0,0001). Stężenia cytokin prozapalnych były znamiennie wyższe u chorych z MAP i SAP niż z PDAC (p < 0,05). Krzywa ROC potwierdza istotną zależność między stężeniem PTX3 a rozpoznaniem PDAC w porównaniu z grupą kontrolną, ze stosunkowo niską czułością i wysoką specyficznością. Nie wykazano istotnej zdolności do różnicowania PDAC z AP (p > 0,05). ...

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“…The aim of this study was to further elucidate the role of PTX3 as a diagnostic and prognostic marker in acute pancreatitis (AP), a potentially strong inflammatory disease, and compare it to CRP. The role of PTX3 as a predictor of severity in AP has previously been studied in AP, with conflicting results 8–10 . Furthermore, a formal link between PTX3, SIRS and disease severity of AP has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

The role of CRP and Pentraxin 3 in the prediction of systemic inflammatory response syndrome and death in acute pancreatitis

Staubli

Schäfer

Rosenthal

et al. 2019

Sci Rep

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Pentraxin 3 (PTX3) is an acute phase protein. Our goal was to assess PTX3 as a predictor of systemic inflammatory response syndrome (SIRS), death and disease severity in acute pancreatitis (AP) in comparison to C-reactive protein (CRP) and the APACHE II score. From April 2011 to January 2015, 142 patients with AP were included in this single center post hoc analysis of prospectively collected data at the University Hospital Basel, Switzerland. Disease severity was rated by the revised Atlanta criteria (rAC). Inflammatory response was measured by the SIRS criteria. PTX3, CRP and APACHE II score were measured. Patients median PTX3 plasma concentrations in AP were higher in moderate (3.311 ng/ml) and severe (3.091 ng/ml) than in mild disease (2.461 ng/ml). Overall, 59 occurrences of SIRS or death were observed. In the prediction of SIRS or death, PTX3 was inferior to CRP and APACHE II, with modest predictive discriminatory ability of all three markers and AUC of 0.54, 0.69 and 0.69, respectively. Upon combination of CRP with PTX3, AUC was 0.7. PTX3 seems to be inferior to CRP and APACHE II in the prediction of SIRS or death in AP and does not seem to improve the predictive value of CRP upon combination of both parameters.

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Plasma cytokines can help to identify the development of severe acute pancreatitis on admission

Abstract: Supplemental Digital Content is available in the text

Cited by 20 publications

References 41 publications

Predictive values of neutrophil-lymphocyte ratio as an early indicator for severe acute pancreatitis in the emergency department patients

Predictive values of neutrophil-lymphocyte ratio as an early indicator for severe acute pancreatitis in the emergency department patients

Clinical usefulness of pentraxin 3 (PTX3) as a biomarker of acute pancreatitis and pancreatic cancer

The role of CRP and Pentraxin 3 in the prediction of systemic inflammatory response syndrome and death in acute pancreatitis

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