title: The value of plasma neurotensin and cytokine measurement for the detection of bowel ischaemia in clinically doubtful cases: a prospective study.
abstract: The aim of this prospective study was to examine whether serum neurotensin, interleukin (IL)-6, and IL-8 are early predictor of bowel ischaemia especially in clinically equivocal cases. To this end, 56 patients were assigned to the following groups according to their disease: bowel ischaemia (group 1: n = 14), small bowel obstruction (group 2: n = 12), acute inflammation (group 3: n = 6), perforation (group 4: n = 8), and colorectal adenocarcinoma (group 5: n = 16). Fifteen healthy controls were assigned to group 6. Blood samples were obtained at enrollment, all measurements were done blindly, and all patients underwent surgery. Pretreatment doubtful diagnosis comprised of ileus, mild abdominal pain, and indeterminate imaging. Blood urea nitrogen, lactic acidosis, diagnostic workup, and IL-6 were predictors of diagnosis in univariate analysis. In multivariate analysis, IL-6 (P < 0.001) and diagnostic workup (P < 0.01) were independent predictors of the definite diagnosis. Neurotensin and IL-8 did not differentiate among groups. Considering clinically doubtful cases, IL-6 perfectly differentiates mesenteric ischaemia (of infarction/embolic/occlusive aetiology) from the rest of the indeterminate pathologies. The optimum cut-off point for IL-6 was 27.66 pg/mL. The value of serum IL-6 (27.66 pg/mL) had sensitivity = 1 and specificity = 1. In conclusion, plasma IL-6 measurement on admission might be an additional diagnostic tool that can predict bowel ischaemia in doubtful clinical situations.
authors.affiliation: Second Surgical Department and Surgical Oncology Unit of Red Cross Hospital, 11526 Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Sgourakis
authors.forename: Aggeliki
authors.initials: A
authors.lastname: Papapanagiotou
authors.forename: Christos
authors.initials: C
authors.lastname: Kontovounisios
authors.forename: Michalis V
authors.initials: MV
authors.lastname: Karamouzis
authors.forename: Sophocles
authors.initials: S
authors.lastname: Lanitis
authors.forename: Chloe
authors.initials: C
authors.lastname: Konstantinou
authors.forename: Constantine
authors.initials: C
authors.lastname: Karaliotas
authors.forename: Athanasios G
authors.initials: AG
authors.lastname: Papavassiliou
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D007415:Intestinal Obstruction / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D007421:Intestine, Small / Q000098:blood supply* / Q000473:pathology; D007511:Ischemia / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009496:Neurotensin / Q000097:blood*; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D009496:Neurotensin
keywords: IL-6; IL-8; acute abdomen; bowel obstruction; mesenteric ischaemia; neurotensin