Is procalcitonin a reliable marker for the diagnosis of infected pancreatic necrosis?
BACKGROUND
Infected necrosis in acute pancreatitis is the main factor in determining the prognosis of the disease. Early and accurate diagnosis of infected pancreatic necrosis might decrease mortality. The aim of the present study is to identify a reliable marker for the onset infection in three different experimentally induced pancreatitis models.


METHODS
Ninety female Wistar albino rats were randomly divided into nine groups. In three different experimental models, including cerulein induced acute oedematous pancreatitis (AEP), sterile pancreatic necrosis due to taurocholate-induced acute pancreatitis (SPN) and infected pancreatic necrosis taurocholate-induced acute pancreatitis (IPN). Serum levels of procalcitonin (PCT), C-reactive protein (CRP), tumour necrosis factor a (TNF-alpha), interleukin 6 (IL-6) and interleukin 8 (IL-8), amylase were measured. The degree of pancreatic damage also evaluated pathologically.


RESULTS
Procalcitonin levels were increased significantly in AEP, SPN and IPN compared to control groups (P < 0.05). PCT and IL-6 level were the highest in the IPN group (P < 0.05). Serum amylase, CRP, TNF-alpha, IL-2, and IL-8 levels were similar between IPN and SPN groups (P > 0.05), but higher than in other groups. The results of histological evaluation also correlated with the advent of the disease.


CONCLUSIONS
Procalcitonin and IL-6 acts as reliable acute phase reactant in an experimental model of AEP, SPN and IPN in the rat. PCT and IL-6 combination might be surrogate marker of infected pancreatic necrosis and should be preferred to other markers assay especially in severe pancreatitis.
Yonetci
Nadir
N
Department of Gastroenterology, Pamukkale University School of Medicine, Denizli, Turkey.
Sungurtekin
Ugur
U
Oruc
Nevin
N
Yilmaz
Mustafa
M
Sungurtekin
Hulya
H
Kaleli
Ilknur
I
Kaptanoglu
Bunyamin
B
Yuce
Gul
G
Ozutemiz
Omer
O
D000818:Animals; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D005260:Female; D009336:Necrosis; D010179:Pancreas / Q000473:pathology*; D010182:Pancreatic Diseases / Q000097:blood* / Q000175:diagnosis* / Q000382:microbiology; D011498:Protein Precursors / Q000097:blood*; D051381:Rats; D017208:Rats, Wistar; D015203:Reproducibility of Results
D015415:Biomarkers; C000606591:Calca protein, rat; D011498:Protein Precursors; D002116:Calcitonin; D015740:Calcitonin Gene-Related Peptide