中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 7
Jul.  2023
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(7): 1657-1664

Value of serum interleukin-6 and tumor necrosis factor-α in early diagnosis of severe acute pancreatitis

DOI: 10.3969/j.issn.1001-5256.2023.07.020

  • Department of Critical Care Medicine, Changshu Hospital Affiliated to Suzhou University & Changshu First People's Hospital, Changshu, Jiangsu 215501, China

Research funding:

Science and Technology Planning Project of Suzhou (cswsq201710);

Science and Technology Planning Project of Suzhou (cs202221)

More Information
  • Corresponding author: ZHANG Jing, csyyhj02@163.com (ORCID: 0000-0003-1050-3608)
  • Received Date: 2022-10-12
  • Accepted Date: 2022-12-27
  • Published Date: 2023-07-20
    Abstract
  •   Objective  To investigate the value of serum cytokines in the early diagnosis of severe acute pancreatitis (SAP), and to improve the accuracy of the diagnosis of SAP by establishing a mathematical model with composite indices based on LASSO algorithm.  Methods  A total of 130 patients with acute pancreatitis (AP) who attended Changshu First People's Hospital from January 2019 to June 2022 were enrolled, among whom there were 73 SAP patients and 57 non-SAP patients.Peripheral serum samples were collected from all patients, and Luminex xMAP liquid chip technique was used to measure 13 serum cytokines.Meanwhile, Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ), Bedside Index for Severity in Acute Pancreatitis (BISAP), and Computed Tomography Severity Index (CTSI) scores were determined for all patients.The Kolmogorov-Smirnov method was used for normality test; the independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups.Furthermore, the binary logistic regression analysis was used to evaluate the effect of cytokines on SAP, and the linear regression analysis was used to investigate the correlation between cytokines and SAP severity.The partial correlation analysis was used to evaluate the correlation between cytokines and SAP severity score after adjustment for covariates[age, sex, body mass index (BMI), and history of hypertension and diabetes].The LASSO algorithm was used to establish a mathematical model with composite indices; the receiver operating characteristic (ROC) curve was used to assess the performance of serum cytokines in the clinical diagnosis of SAP, and the area under the ROC curve (AUC) was calculated.  Results  Compared with the SAP group, the non-SAP group had significantly lower APACHE Ⅱ, BISAP, CTSI, and modified Marshall scores (all P < 0.001).Compared with the non-SAP group, the SAP group had significantly higher levels of interferon-γ(IFN-γ), interleukin-6(IL-6), interleukin-8, and tumor necrosis factor-α(TNF-α) and a significantly lower level of interleukin-12(all P < 0.05).The logistic regression analysis showed that IFN-γ(odds ratio[OR]=1.190, 95% confidence interval[CI]: 1.036-1.367, P=0.014), IL-6 (OR=1.148, 95%CI: 1.070-1.231, P < 0.001), and TNF-α (OR=1.100, 95%CI: 1.048-1.155, P < 0.001) were independent influencing factors for SAP.The partial correlation analysis showed that after adjustment for sex, age, BMI, and history of chronic diseases (diabetes and hypertension), the levels of IL-6 and TNF-α were positively correlated with APACHE Ⅱ score in SAP patients (IL-6:r=0.503, P < 0.001;TNF-α: r=0.557, P < 0.001).The linear regression analysis showed that the levels of IL-6 and TNF-α were associated with APACHE Ⅱ score in SAP patients (IL-6:β=0.049, P=0.044;TNF-α: β=0.054, P=0.046), and there was an interaction between IL-6 and TNF-α, which affected APACHE Ⅱ score.The ROC curve analysis showed that the risk score based on IL-6 and TNF-α using LASSO algorithm had the largest AUC of 0.925 in distinguishing SAP from non-SAP, while IL-6 or TNF-α alone had an AUC of 0.885 and 0.878, respectively.The partial correlation analysis showed that after adjustment for sex, age, BMI, and history of chronic diseases (diabetes and hypertension), the risk score was positively correlated with APACHE Ⅱ score in SAP patients (r=0.565, P < 0.001).  Conclusion  The serum levels of IL-6 and TNF-α can reflect the severity of AP.The risk score combining serum IL-6 and TNF-α can significantly improve the accuracy of the early diagnosis of SAP, which has an important clinical value in the clinical diagnosis and treatment of SAP.

     

    • FullText(HTML)
  • loading
    • References(18)
  • [1]
    BANKS PA, BOLLEN TL, DERVENIS C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1): 102-111. DOI: 10.1136/gutjnl-2012-302779.
    [2]
    LANKISCH PG, APTE M, BANKS PA. Acute pancreatitis[J]. Lancet, 2015, 386(9988): 85-96. DOI: 10.1016/S0140-6736(14)60649-8.
    [3]
    BOXHOORN L, VOERMANS RP, BOUWENSE SA, et al. Acute pancreatitis[J]. Lancet, 2020, 396(10252): 726-734. DOI: 10.1016/S0140-6736(20)31310-6.
    [4]
    STAUBLI S M, OERTLI D, NEBIKER CA. Laboratory markers predicting severity of acute pancreatitis[J]. Crit Rev Clin Lab Sci, 2015, 52(6): 273-283. DOI: 10.3109/10408363.2015.1-051659.
    [5]
    LUO XP, WANG J, WU Q, et al. Research advances in acute pancreatitis scoring system[J]. J Clin Hepatol, 2022, 38(9): 2188-2192. DOI: 10.3969/j.issn.1001-5256.2022.09.046.

    罗秀平, 王洁, 吴青, 等. 急性胰腺炎评分系统的研究进展[J]. 临床肝胆病杂志, 2022, 38(9): 2188-2192. DOI: 10.3969/j.issn.1001-5256.2022.09.046.
    [6]
    KENEZ J. Charles Richet and the development of immuno-allergology[J]. Orv Hetil, 1975, 116(42): 2489-2492. DOI: 10.1016/S0140-6736(08)60107-5.
    [7]
    BHATIA M, WONG FL, CAO Y, et al. Pathophysiology of acute pancreatitis[J]. Pancreatology, 2005, 5(2-3): 132-144. DOI: 10.1159/000085265.
    [8]
    Pancreatic Surgery Group, Chinese Society of Surgery, Chinese Medical Association, Guidelines for diagnosis and treatment of acute pancreatitis in China (2021)[J]. Chin J Dig Surg, 2021, 20(7): 730-739. DOI: 10.3760/cma.j.cn112139-20210416-00172.

    中华医学会外科学分会胰腺外科学组. 中国急性胰腺炎诊治指南(2021)[J]. 中华消化外科杂志, 2021, 20(7): 730-739. DOI: 10.3760/cma.j.cn112139-20210416-00172.
    [9]
    ZHUANG J, ZHU WW, ZHANG C. Establishment and validation of a noninvasive diagnostic model for chronic hepatitis B liver fibrosis based on LASSO regression[J]. J Clin Hepatol, 2022, 38(8): 1790-1795. DOI: 10.3969/j.issn.1001-5256.2022.08.014.

    壮健, 朱韦文, 张超. 基于LASSO回归的慢性乙型肝炎肝纤维化无创诊断模型的构建及验证[J]. 临床肝胆病杂志, 2022, 38(8): 1790-1795. DOI: 10.3969/j.issn.1001-5256.2022.08.014.
    [10]
    GIBOR U, PERRY Z, NETZ U, et al. Circulating cell-free DNA in patients with acute biliary pancreatitis: association with disease markers and prolonged hospitalization time-A prospective cohort study[J]. Ann Surg, 2020, 2(3): 77-78. DOI: 10.1097/SLA.0000000000004679.
    [11]
    STERNBY H, HARTMAN H, THORLACIUS H, et al. The initial course of IL1β, IL-6, IL-8, IL-10, IL-12, IFN-γ and TNF-α with regard to severity grade in acute pancreatitis[J]. Biomolecules, 2021, 11(4). DOI: 10.3390/biom11040591.
    [12]
    AOUN E, CHEN J, REIGHARD D, et al. Diagnostic accuracy of interleukin-6 and interleuk- in-8 in predicting severe acute pancreatitis: a meta-analysis[J]. Pancreatology, 2009, 9(6): 777 -785. DOI: 10.1159/000214191.
    [13]
    LIANG ZX, PAN WC, MAI JW, et al. Application value of serum hs-CRP, IL-6 and TNF-α in the evaluation of acute pancreatitis[J]. Chin J Mod Drug Appl, 2020, 14(22): 48-50. DOI: 10.14164/j.cnki.cn11-5581/r.2020.22.021.

    梁灼星, 潘伟才, 麦静雯, 等. 血清hs-CRP、IL-6、TNF-α在急性胰腺炎病情评估中的应用价值研究[J]. 中国现代药物应用, 2020, 14(22): 48-50. DOI: 10.14164/j.cnki.cn11-5581/r.2020.22.021.
    [14]
    DI GIOIA M, SPREAFICO R, SPRINGSTEAD JR, et al. Endogenous oxidized phospholipids reprogram cellular metabolism and boost hyperinflammation[J]. Nat Immunol, 2020, 21(1): 42-53. DOI: 10.1038/s41590-019-0539-2.
    [15]
    YE M, JOOSSE M E, LIU L, et al. Deletion of IL-6 exacerbates colitis and induces systemic inflammation in IL-10-deficient mice[J]. J Crohns Colitis, 2020, 14(6): 831-840. DOI: 10.1093/ecco-jcc/jjz176.
    [16]
    ZHANG XP, CHEN L, HU QF, et al. Effects of large dose of dexamethasone on inflammatory mediators and pancreatic cell apoptosis of rats with severe acute pancreatitis[J]. World J Gastroenterol, 2007, 13(41): 5506-5511. DOI: 10.3748/wjg.v13.i41.5506.
    [17]
    HUANG Z, MA X, JIA X, et al. Prevention of severe acute pancreatitis with cyclooxygenase-2 inhibitors: A randomized controlled clinical trial[J]. Am J Gastroenterol, 2020, 115(3): 473-480. DOI: 10.14309/ajg.0000000000000529.
    [18]
    HE WH, ZHENG X, ZHU Y, et al. Comparison of APACHEⅡ, Ranson, BISAP and CTSI scores in early prediction of the severity of acute pancreatitis based on large sample database[J]. Chin J Pancreatol, 2019, 19(3): 172-176. DOI: 10.3760/cma.j.issn.1674-1935.2019.03.004.

    何文华, 郑西, 祝荫, 等. 基于大样本数据库比较APACHEⅡ、Ranson、BISAP和CTSI评分在早期预测急性胰腺炎病情严重程度的价值[J]. 中华胰腺病杂志, 2019, 19(3): 172-176. DOI: 10.3760/cma.j.issn.1674-1935.2019.03.004.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (324) PDF downloads(48) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return