SIGNIFICANT ELEVATION OF SERUM HUMAN HEPATOCYTE GROWTH-FACTOR LEVELS IN PATIENTS WITH ACUTE-PANCREATITIS

Serum levels of human hepatocyte growth factor (HGF) were determined i n 38 patients with acute pancreatitis by an enzyme-linked immunosorben t assay. The mean value of serum HGF levels on admission in the 38 pat ients was 1.69 +/- 0.40 (SEM) ng/ml. In 35 patients, serum HGF levels were found to be positive (>0.39 ng/ml), with an incidence of 92.1%. I n 17 patients, they were >1.0 ng/ml, which was the cutoff value for fu lminant hepatic failure. Serum HGF levels in the patients with severe- acute pancreatitis (2.30 +/- 0.61 ng/ml; mean +/- SEM) were significan tly higher than those in the patients with mild and moderate acute pan creatitis (0.63 +/- 0.06 ng/ml). Sixteen of seventeen patients whose s erum HGF levels were >1.0 ng/ml were evaluated as severe acute pancrea titis. Serum HGF levels were significantly elevated in the patients wi th higher Ranson scores, higher APACHE II scores, or higher computed t omography grades. Serum HGF levels in the patients with organ dysfunct ion (liver, kidney, or lung) were significantly higher than those in t he patients without organ dysfunction. Moreover, serum HGF levels on a dmission in the nonsurvivors (3.17 +/- 1.30 ng/ml) were significantly higher than those in the survivors (1.22 +/- 0.33 ng/ml). The mortalit y rate of the patients showing serum HGF levels >2.0 ng/ml on admissio n was 50%. In the patients with a lethal outcome, the mean serum HGF l evel remained constantly >2.50 ng/ml during hospitalization. The serum HGF level reflected the clinical course of the disease rapidly and di stinctly. Serum HGF levels increased with complications such as organ failure, infected pancreatic necrosis, and sepsis and decreased with s uccessful intensive and surgical treatments. These results suggest tha t serum human HGF levels may reflect the severity, organ dysfunction, and prognosis in acute pancreatitis.