A Meta-analysis For The Diagnositc Value Of Procalcitonin In The Early Prediction Of Severe Acute Pancreatitis

Objective:To review systematically the diagnostic value of serum procalcitonin(PCT) in the early prediction of severe acute pancreatitis(SAP).Methods:The data of Springer, PubMed, The Cochrane Library, China National Knowledge Inf-rastructure(CNKI), Chinese biomedical literature database(CBM) and Chinese Science and Technology Periodical Database were collected, and some original studies were analyzed. The QUADAS items were used for quality assessment in our systematic review. Meta-disc software was used to analyze pooled sensitivity, pooled specificity, pooled positive likelihood ratio and pooled negative likelihood ratio, pooled diagnostic test odds ratio and heterogeneity test, and draw summary receiver operator characteristic curve (SROC). And compared with the acute physiology and chronic health evaluationâ…¡(APACHEâ…¡) score which were widely used in clinic.Results:We searched 218 relevant English articles,85 Chinese articles. Eight articles (6 English articles,2 Chinese articles) were included, with total 650 patients. Eight articles meeting inclusion criteria were analyzed for the value of the serum PCT levels test for the diagnose is of clinical SAP at Within 24 hours of onset, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and SROC AUC were 66.7%(95%CI:59.4%-73.4%),82.8% (95%CI:79.0%-86.1%),3.389 (95%CI:2.232-5.145),0.423 (95%CI:0.199-0.900) and 0.7871, respectively. Four articles were analyzed for the value of the APACHE II score test for the diagnose is of clinical SAP at the same time (To score>8 as diagnostic criteria), the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and SROC AUC were 63.0%(95%CI:53.7%-71.7%),77.4%(95%CI:72.6%-81.8%),2.863 (95%CI:1.791-4.577), 0.469 (95%CI:0.279-0.788) and 0.7844, respectively. And 79.8%(95%CI:71.5%-86.6%) 84.0%(95%CI:79.6%-87.7%),4.567 (95%CI:3.508-5.947),0.263 (95%CI:0.187-0.370) and 0.8824 for PCT.ConclusionrThe PCT test showed good accuracy in diagnosing SAP, every indicator is better than APACHEâ…¡, Within 24 hours of onset can be an effective forecast. It will become a simple biochemical maker in the early prediction of SAP.