SERUM INTERLEUKIN-6, INTERLEUKIN-8, AND BETA(2)-MICROGLOBULIN IN EARLY ASSESSMENT OF SEVERITY OF ACUTE-PANCREATITIS - COMPARISON WITH SERUMC-REACTIVE PROTEIN

The aim of this study was to compare the sensitivity, specificity, and diagnostic accuracy of serum interleukin-6, interleukin-8, beta(2)-mi croglobulin, and C-reactive protein in the assessment of the severity of acute pancreatitis using commercial kits for their respective assay s. Thirty-eight patients with acute pancreatitis (25 men, 13 women, me an age 59 years, range 16-97) were studied; the diagnosis was based on prolonged upper abdominal pain associated with a twofold increase of serum lipase, and it was confirmed by imaging techniques. According to the Atlanta criteria, 15 patients had severe illness and 23 had mild disease. The four serum markers were determined in all patients on adm ission, as well as daily for the following five days. On the first day of the disease, the sensitivity (calculated on patients with severe p ancreatitis), specificity (calculated on patients with mild pancreatit is), and the diagnostic accuracy of these serum markers for establishi ng the severity of acute pancreatitis were 100%, 86%, and 91% for inte rleukin-6 (cutoff level 2.7 pg/ml); 100%, 81%, and 88% for interleukin -8 (cutoff level 30 pg/ml); 58%, 81%, and 73% for beta(2)-microglobuli n (cutoff level 2.1 mg/liter); and 8%, 95%, and 64% for C-reactive pro tein (cutoff level 11 mg/dl). The results of our study indicate that, when assayed during the first 24 hr of disease onset, interleukin-6 an d interleukin-8 are better markers than beta(2)-microglobulin or C-rea ctive protein for evaluating the severity of acute pancreatitis.