Serum amyloid A, procalcitonin, and C-reactive protein in early assessmentof severity of acute pancreatitis

Amyloid A (SAA) and procalcitonin (PCT) have been reported as useful indica tors of inflammation. Our aim was to assess the utility of SAA and PCT in e stablishing the severity of acute pancreatitis in comparison to C-reactive protein (CRP): similar to Thirty-one patients with acute pancreatitis enrol led within 24 hr from the onset of pain and 31 healthy subjects were studie d. Nineteen patients had mild acute pancreatitis, and 12 had severe pancrea titis. Serum SAA, PCT, and CRP were measured in all subjects at admission a nd, in acute pancreatitis patients, during the following five days. similar to Patients with acute pancreatitis had serum concentrations of SAA, PC si milar to T, and CRP significantly higher (P < 0.001) than those of healthy subjects during the entire study period. Using cutoff values ranging from 2 40 to 250 mg/liter for SAA, from 0.252 to 0.255 ng/ml for PCT, and from 12. 8 to 12.9 mg/dl for CRP, the sensitivity (calculated on patients with sever e pancreatitis), the specificity (calculated on patients with mild pancreat itis), and the efficiency (calculated as the percentage of correct classifi cations) were 76.8%, 69.3%, and 72.4% for SAA; 21.7%, 83.2%, and 58.2% for PCT; and 60.9%, 89.1%. and 77.6% for CRP. In conclusion, the sensitivity of SAA is significantly higher than that of PCT and CRP in assessing the seve rity of pancreatitis, whereas PCT and CRP had a specificity significantly h igher than SAA. The accuracy and efficiency were similar for SAA and CRP, a nd both these markers had an accuracy and efficiency significantly higher t han those of PCT.