Initial exploration of single markers on the evaluation for severity of acute pancreatitis

Objective To investigate the effects of serum C-response protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8) and tumor necrosis factor-alpha(TNF-α) on evaluating the severity of acute pancreatitis at early stage.Methods Thirty-one patients with acute pancreatitis who were diagnosed according to the criteria in 1996,were divided into severe acute pancreatitis group(SAP,n=14) and mild acute pancreatitis group(n=17).Nine healthy individuals were employed as the control group.The serum CRP were detected by super-sensitive method,while the serum IL-6,IL-8 and TNF-α by ELISA.Results (1)In SAP group,mild group and control group,the serum levels of CRP,IL-6 and TNF-α decreased in order(P0.05).IL-8 in the SAP group was higher than that in mild group(118.00±96.14 ng/L vs 40.76± 33.19 ng/L,P0.05) and the control group(118.00±96.14 ng/L vs 22.46±13.35 ng/L,P 0.05),but there was no significant difference between the mild group and control group(40.76±33.19ng/L vs 22.46±13.35ng/L,P=0.387).(2)The serum CRP,IL-6,IL-8 and TNF-α were related to the severity of acute pancreatitis.(3)The diagnostic efficiencies of them have no significant difference.(4)When the cut-off points was 40 mg/L for CRP,19.5ng/L for IL-6,28ng/L for IL-8 and 6.4ng/L for TNF-α,the sensitivity (calculated on patients with SAP),specificity (calculated on patients with mild acute pancreatitis) were 85.71% and 64.71% for CRP,78.57% and 76.47% for IL-6,92.86% and 52.94% for IL-8 and TNF-α.(5)When two of the four markers were combined in serial tests,the sensitivity and specificity were 85.71% and 88.24% for IL-8 combining with TNF-α.Conclusion There were positive correlation between the concentration of serum CRP,IL-6,IL-8 and TNF-α and the severity of acute pancreatitis.These markers can be used as valuable indexes to predict the severity of acute pancreatitis at the early stage,and when both of them are combined in serial tests,the sensitivity or the specificity increased.