Serum adhesion molecules in acute pancreatitis: time course and early assessment of disease severity.
OBJECTIVE
To evaluate the adhesion molecule time course in the early phases of acute pancreatitis and to explore the usefulness of these proteins in assessing the severity of the disease. Fifteen consecutive acute pancreatitis patients (10 patients with the mild and 5 with the severe disease) admitted to the hospital within 6 hours after the onset of pain and 15 age- and sex-matched healthy subjects.


METHODS
Vascular cell adhesion molecule 1, intercellular adhesion molecule 1, E-selectin, P-selectin, and L-selectin were quantified on hospital admission and for the following 2 days.


RESULTS
Acute pancreatitis patients had vascular cell adhesion molecule 1 and P-selectin concentrations significantly lower and L-selectin concentrations significantly higher than the healthy subjects. Only E-selectin was significantly higher in severe than in mild disease (P = 0.029); a value of E-selectin ranging from 3.83 to 3.92 ng/mL was the best cutoff value for differentiating severe from mild acute pancreatitis (sensitivity: 60.0%, specificity: 90.0%, cases correctly classified: 80%). E-selectin and P-selectin entered the multivariate logistic regression analysis, and a score was calculated showing a sensitivity of 93.3% and a specificity of 86.7% in identifying the patients with severe pancreatitis.


CONCLUSIONS
This score seems to be useful for the early assessment of the severity of acute pancreatitis.
Pezzilli
Raffaele
R
Department of Internal Medicine and Gastroenterology, S Orsola Hospital, Bologna, Italy. raffaele.pezzilli@aosp.bo.it
Corsi
Massimiliano M
MM
Barassi
Alessandra
A
Morselli-Labate
Antonio M
AM
D'Alessandro
Alessandro
A
Dogliotti
Giada
G
Fantini
Lorenzo
L
Malesci
Alberto
A
Corinaldesi
Roberto
R
Melzi d'Eril
Gianvico
G
D000368:Aged; D016022:Case-Control Studies; D015815:Cell Adhesion Molecules / Q000097:blood*; D003937:Diagnosis, Differential; D019040:E-Selectin / Q000097:blood*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D019041:L-Selectin / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*; D010195:Pancreatitis / Q000175:diagnosis / Q000276:immunology*; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000276:immunology*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013997:Time Factors; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D015815:Cell Adhesion Molecules; D019040:E-Selectin; D019007:P-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D019041:L-Selectin