Elevation of plasma tissue factor levels in patients with severe acute pancreatitis.
BACKGROUND
Coagulative disorders are known to occur in severe acute pancreatitis (SAP), and they are related to its severity and organ dysfunctions. Tissue factor (TF) is a transmembrane glycoprotein that activates the extrinsic pathway of the blood coagulation cascade. Plasma TF levels increase in patients with sepsis and acute coronary syndrome. However, plasma TF levels in SAP have not yet been reported.


METHODS
We measured plasma TF antigen levels by enzyme-linked immunosorbent assay in 36 patients with acute pancreatitis at the time of admission. The relationships between their plasma TF levels and various factors (severity, etiology, pancreatic necrosis, organ dysfunction, and prognosis) were analyzed. The utility of plasma TF as a clinical marker was evaluated.


RESULTS
Plasma TF levels significantly increased in patients with SAP compared with healthy volunteers and drinkers, respectively. Plasma TF level in alcoholic SAP with pancreatic necrosis was significantly higher than that in alcoholic SAP without pancreatic necrosis or that in nonalcoholic SAP with pancreatic necrosis. The incidence of an abnormally high level of plasma TF was 63.6% in alcoholic SAP with pancreatic necrosis. The area under the ROC curve of plasma TF for detection of pancreatic necrosis in alcoholic SAP was 0.773 and was superior to those of Japanese severity score and lactate dehydrogenase.


CONCLUSIONS
Plasma TF levels were elevated in patients with SAP, particularly in those with alcoholic SAP with pancreatic necrosis, suggesting that TF may be closely related to the development of pancreatic necrosis in alcoholic SAP and that the plasma TF level may be a useful marker for it.
Sawa
Hidehiro
H
Department of Gastroenterological Surgery, Kobe University Graduate School of Medical Sciences, Kobe, 650-0017, Japan.
Ueda
Takashi
T
Takeyama
Yoshifumi
Y
Yasuda
Takeo
T
Matsumura
Naoki
N
Nakajima
Takahiro
T
Ajiki
Tetsuo
T
Fujino
Yasuhiro
Y
Suzuki
Yasuyuki
Y
Kuroda
Yoshikazu
Y
D000208:Acute Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood*; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood; D012720:Severity of Illness Index; D013925:Thromboplastin / Q000032:analysis*
D013925:Thromboplastin