The Value Of Procalcitonin And STREM-1in Early Predicting The Severity Of Acute Pancreatitis

Objective:Through testing the levels of serum procalcitonin and soluble triggering receptor expressed on myeloid cells-1and monitoring the dynamic changes, debating their value in early predicting the severity of acute pancreatitis. Exploring diagnosis cut-off points of PCT for SAP and its correlations with sTREM-1, in addition to compare their diagnostic capacities with other forecasting methodsMethods:34patients with acute pancreatitis from August2012to December2012in Xiangya Hospital were collected in this study. These patients were classified into mild acute pancreatitis group(16cases) and severe acute pancreatitis group(18cases). Twenty healthy volunteers were also included as the control group. Blood samples were obtained at post-admission Id,4d,7d to detect the concentrations of PCT and sTREM-1. APACHE II score, CTSI score and BISAP score were also calculated. Then the differences among the groups were analyzed.Results:(1) The concentrations of PCT within7days after admission were obviously higher in patients of severe acute pancreatitis group than mild acute pancreatitis group (P<0.001) in the same period; At the best cut-off level of1.56ng/ml, diagnostic sensitivity and specificity of PCT for SAP is88.9%and100%.(2) The concentrations of sTREM-1at post-admission Id in patients of severe acute pancreatitis group were higher than mild acute pancreatitis group(P<0.005) and the control group(P<0.001), sTREM-1levels in patients of mild acute panereatitis group were higher than the control group (P<0.001); The concentrations of sTREM-1within7days after admission were obviously higher in patients of severe acute pancreatitis group than mild acute pancreatitis group (P<0.05) in the same period; Expressions of sTREM-1had positive correlations with APACHE II, CTSI and BISAP respectively (P<0.05); At cut-off level of0.41ng/ml, the levels of sTREM-lshowed sensitivity of66.7%, specificity of93.8%for the diagnosis of SAP. (3) Spearman’s rank correlation analysis found that PCT expression was positive related with sTREM-1expression in acute pancreatitis patients(r=0.471, P<0.01).(4) Receiver operating characteristic cure showed that compari ng with APACHE II(AUC=0.882), sTREM-1(AUC=0.839), the diagno stic capacity for SAP of PCT(AUC=0.96) was the best of all above.Conclusion:(1) PCT is an ideal early predictor of SAP, the best diagnostic cut-off value of PCT for SAP is1.56ng/ml.(2) The serum sTREM-1has a close relationship with the severity of acute pancreatitis, which could be promising biomarker in early predicting the severity of acute pancreatitis.(3) At the early stage of acute pancreatitis, PCT is positive related with sTREM-1and are both involved in the inflammatory reaction process.