title: Serum matrix metalloproteinase-9 is an early marker of pancreatic necrosis in patients with severe acute pancreatitis.
abstract: OBJECTIVE
  To study the ability of matrix metalloproteinase-9 (MMP-9) to predict pancreatic necrosis (PN) in patients with severe acute pancreatitis (SAP).
  
  
  METHODS
  From July 1, 2010 to December 31, 2010 patients diagnosed with SAP were included (n=35). Serum MMP-9, CRP and IL-6 were analyzed on days 1, 3, 5 and 7 of hospitalization to determine if they could predict the development of pancreatic necrosis.
  
  
  RESULTS
  Of the 35 patients included, 12 (34.3%) had evidence of PN. Admission MMP-9 concentrations were significantly higher in patients with PN compared to subjects without PN (13.1±4.0 vs. 7.5±3.8, p<0.05). Receiver operating characteristic curves for PN revealed an area under the curve of 0.832 for admission MMP-9 (95% confidence interval 0.696-0.967, p=0.001). Elevated concentrations of MMP-9 on admission for pancreatic necrosis =9.35mg/L yielded a positive predictive value of 90.9% with a sensitivity of 91.7% and a specificity of 69.6%. Binary logistic regression indicated that MMP-9 was significantly associated with pancreatic necrosis (Odds ratios 25.1, 95% confidence interval 2.7-234.2; p=0.005).
  
  
  CONCLUSIONS
  An elevation in serum MMP-9 within the first 24 hours of disease is strongly associated with the development of pancreatic necrosis. This finding may have important clinical implications and requires further investigation.
authors.affiliation: Department of Integrated Traditional Chinese and Western Medicine, Sichuan University, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Guo
authors.forename: Ping
authors.initials: P
authors.lastname: Xue
authors.forename: Xiao-Nan
authors.initials: XN
authors.lastname: Yang
authors.forename: Xu-Bao
authors.initials: XB
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.forename: Qing
authors.initials: Q
authors.lastname: Xia
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016001:Confidence Intervals; D005260:Female; D018398:Homeodomain Proteins; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016015:Logistic Models; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve
chemical_list: D015415:Biomarkers; C473013:Hod protein, mouse; D018398:Homeodomain Proteins; D015850:Interleukin-6; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9