R. Pezzilli et al., Simultaneous serum assays of lipase and interleukin-6 for early diagnosis and prognosis of acute pancreatitis, CLIN CHEM, 45(10), 1999, pp. 1762-1767
Background: There are no systems for the rapid diagnosis and prognosis of a
cute pancreatitis in the Emergency Department. Our aim was to evaluate whet
her the combined use of serum lipase and interleukin-6 or serum lipase and
C-reactive protein is able to simultaneously establish both the diagnosis a
nd the prognosis of acute pancreatitis,
Methods: Eighty patients with acute abdomen were studied on admission to th
e Emergency Room. Forty patients had nonpancreatic acute abdomen, and 40 ha
d acute pancreatitis (25 had mild acute pancreatitis and 15 had severe panc
reatitis). Forty healthy subjects comparable for sex and age were also stud
ied as controls. Lipase, interleukin-6 and C-reactive protein were determin
ed on serum in all subjects.
Results: Using lipase to discriminate between patients with nonpancreatic a
cute abdomen and patients with acute pancreatitis (cutoff values ranging fr
om 419 to 520 U/L), one patient with acute pancreatitis was not identified
correctly. To discriminate between patients with severe acute pancreatitis
and those with mild pancreatitis in the remaining 39 patients, interleukin-
6 (cutoff value, <3.7 mu g/L) had a sensitivity of 100% (15 of 15) and a sp
ecificity of 83% (20 of 24); 75 of 80 (94%) patients were classified correc
tly. C-reactive protein (cutoff values ranging from 6 to 7 mg/L) showed a l
ower prognostic efficiency than interleukin-6: sensitivity of 87% (13 of 15
) and specificity of 46% (11 of 24). Sixty-four of 80 patients (80%) were c
lassified correctly. The area under the ROC curve for interleukin-6 (0.911
+/- 0.049) was significantly (P = 0.013) greater than that for C-reactive p
rotein (0.685 +/- 0.090).
Conclusion: The combined use of serum lipase and interleukin-6 is useful in
simultaneously establishing both the diagnosis and the prognosis of acute
pancreatitis. (C) 1999 American Association for Clinical Chemistry.