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Şiddetli pankreatiti öngörmede yeni biyobelirteç; Sistemik immün-inflamasyon indeksi

Yıl 2023, Cilt: 14 Sayı: 3, 464 - 469, 30.09.2023

Şener Balas Nurhak Cihangir Çınkıl Muhammed Apaydın

https://doi.org/10.18663/tjcl.1333413

Öz

Amaç: Akut pankreatit (AP), pankreasta sıklıkla peripankreatik dokuları, bazen de uzak dokuları tutan akut inflamatuar bir süreçtir. Şiddetli akut pankreatiti(ŞAP) öngörmede kolay, hızlı ve ucuz biyobelirteçleri tanımlamak bir ihtiyaçtır. Birçok çalışmada da SII anlamlı bir inflamasyon öngörücüsü olarak gösterilmiştir. Bu çalışmada SII’ın ŞAP’ı öngörmede prediktif değerini ortaya koymayı amaçladık.
Gereç ve Yöntemler: Bu retrospektif çalışma Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu’nun 12.09.2022 tarihli 146/08 karar numaralı onayı ile yapıldı. Çalışmaya hastanemizde akut pankreatit ile yatarak tedavi görmüş 131 hasta dahil edildi. SII’ın ŞAP’ı öngörmede prediktif değeri karşılaştırmalı analiz ve ROC analizi ile değerlendirildi.
Bulgular: Çalışmaya 59’u(%45) kadın 72’si(%55) erkek toplam 131 hasta dahil edildi. Bunların 95’i(%72,5) HAP ile 36’sı(%22,5) ŞAP ile takip edilen hastalardı. HAP grubuna göre serviste yatış süresi ve yoğun bakımda yatış süresi anlamlı olarak yüksekti(p<0,01). İki grup karşılaştırıldığında SII değerleri ŞAP grubunda anlamlı olarak daha yüksek saptandı (p<0,01). Yapılan ROC analizinde; SII ≥ 1660,36 için istatistiksel anlamlı bir değer elde edildi (p<0,001). Serum SII ≥ 1660,36 kesim değeri için; duyarlılık %72,2; özgüllük %91,6; pozitif prediktif değeri %76; negatif prediktif değeri ise %90 bulundu. Eğri altındaki alan (EAA) değeri 0,89 ve standart hatası 0,029 olarak saptandı (p=0,001).
Sonuç: Bu çalışma, SII değeri 1660,36’dan yüksek olan AP hastalarının ŞAP olma olasılığının daha yüksek olduğunu göstermiştir. SII, herhangi bir nedenle akut inflamasyonun tetiklediği otoinflamatuar kaskadın bir belirtecidir. Acil servise başvuran ve acil servise başvuruda hesaplandığında AP tanısı alan hastaların klinik sonuçlarını tahmin etmek için faydalı bir skorlama sistemi olabilir.

Anahtar Kelimeler

pankreatit SII sistemik İmmün-inflamasyon indeksi

Destekleyen Kurum

YOK

Kaynakça

  • Vege S, Yadav D, Chari S. Pancreatitis. GI Epidemiology, Talley NJ, Locke GR, Saito YA. Blackwell Publishing, Malden, MA; 2007.
  • Bogan BD, McGuire SP, Maatman TK. Readmission in acute pancreatitis: Etiology, risk factors, and opportunities for improvement. Surgery Open Science. 2022;10:232-7. doi: 10.1016/j.sopen.2022.10.010. PubMed PMID: S2589845022000719.
  • Banks PA, Freeman ML, Gastroenterology PPCotACoGJOjotACo, ACG. Practice guidelines in acute pancreatitis. 2006;101(10):2379-400.
  • Pandol SJ, Saluja AK, Imrie CW, Banks PAJG. Acute pancreatitis: bench to the bedside. 2007;133(3):1056. e1-. e25.
  • Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-11. Epub 2012/10/27. doi: 10.1136/gutjnl-2012-302779. PubMed PMID: 23100216.
  • Yang CJ, Chen J, Phillips AR, Windsor JA, Petrov MS. Predictors of severe and critical acute pancreatitis: a systematic review. Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. 2014;46(5):446-51. Epub 2014/03/22. doi: 10.1016/j.dld.2014.01.158. PubMed PMID: 24646880.
  • Feng JF, Chen S, Yang X. Systemic immune-inflammation index (SII) is a useful prognostic indicator for patients with squamous cell carcinoma of the esophagus. Medicine. 2017;96(4):e5886. Epub 2017/01/26. doi: 10.1097/md.0000000000005886. PubMed PMID: 28121932; PubMed Central PMCID: PMCPMC5287956.
  • Hong X, Cui B, Wang M, Yang Z, Wang L, Xu Q. Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer. The Tohoku journal of experimental medicine. 2015;236(4):297-304. Epub 2015/08/08. doi: 10.1620/tjem.236.297. PubMed PMID: 26250537.
  • Lolli C, Caffo O, Scarpi E, et al. Systemic Immune-Inflammation Index Predicts the Clinical Outcome in Patients with mCRPC Treated with Abiraterone. Frontiers in pharmacology. 2016;7:376. Epub 2016/10/30. doi: 10.3389/fphar.2016.00376. PubMed PMID: 27790145; PubMed Central PMCID: PMCPMC5062111.
  • Lolli C, Basso U, Derosa L, et al. Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib. Oncotarget. 2016;7(34):54564-71. Epub 2016/07/14. doi: 10.18632/oncotarget.10515. PubMed PMID: 27409344; PubMed Central PMCID: PMCPMC5342364.
  • Liu X, Guan G, Cui X, Liu Y, Liu Y, Luo F. Systemic Immune-Inflammation Index (SII) Can Be an Early Indicator for Predicting the Severity of Acute Pancreatitis: A Retrospective Study. International journal of general medicine. 2021;14:9483-9. Epub 2021/12/25. doi: 10.2147/ijgm.S343110. PubMed PMID: 34949937; PubMed Central PMCID: PMCPMC8689009.
  • Kaplan M, Ates I, Oztas E, et al. A New Marker to Determine Prognosis of Acute Pancreatitis: PLR and NLR Combination. Journal of medical biochemistry. 2018;37(1):21-30. Epub 2018/12/26. doi: 10.1515/jomb-2017-0039. PubMed PMID: 30581338; PubMed Central PMCID: PMCPMC6294107.
  • Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clinical cancer research : an official journal of the American Association for Cancer Research. 2014;20(23):6212-22. Epub 2014/10/02. doi: 10.1158/1078-0432.Ccr-14-0442. PubMed PMID: 25271081.
  • Werner J, Feuerbach S, Uhl W, Büchler MW. Management of acute pancreatitis: from surgery to interventional intensive care. Gut. 2005;54(3):426-36. Epub 2005/02/16. doi: 10.1136/gut.2003.035907. PubMed PMID: 15710995; PubMed Central PMCID: PMCPMC1774421.
  • Zerem E. Treatment of severe acute pancreatitis and its complications. World journal of gastroenterology. 2014;20(38):13879-92. Epub 2014/10/17. doi: 10.3748/wjg.v20.i38.13879. PubMed PMID: 25320523; PubMed Central PMCID: PMCPMC4194569.

New biomarker to predict severe pancreatitis; Systemic ımmuno-inflammation

Yıl 2023, Cilt: 14 Sayı: 3, 464 - 469, 30.09.2023

Şener Balas Nurhak Cihangir Çınkıl Muhammed Apaydın

https://doi.org/10.18663/tjcl.1333413

Öz

Aim: Acute pancreatitis (AP) is an acute inflammation of the pancreas that affects cells, peripancreatic tissues, and sometimes distant tissues. It can range from mild forms needing observation to severe forms with multiple organ failure and death. Thus, there is a need for simple, fast, and affordable biomarkers to predict acute diary pancreatitis. The SII can predict inflammation. This study aimed to assess the SII's predictive value for severe acute pancreatitis (SAP).
Material and Methods: This retrospective study, approved by Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital's Ethics Committee (decision 146/08, 12.09.2022), involved 131 patients over 18 hospitalized with acute pancreatitis. The SII's predictive value for SAP was evaluated using comparative and ROC analyses.
Results: The study included 131 patients 72.5% were followed up with HAP and 22.5% with SAP. Length of stay in the ward and ICU was significantly higher in the HAP group (p<0.01). The SII values of the SAP group were significantly higher than the other group (p<0.01). ROC analysis showed that SII ≥ 1660.36 was a reliable biomarker for SAP (p<0.001). For this cutoff value, sensitivity was 72.2%, specificity 91.6%, positive predictive value 76%, and negative predictive value 90%. AUC was 0.89 (SE=0.029, p=0.001).
Conclusion: The study revealed that acute pancreatitis (AP) patients with a systemic immune-inflammation index (SII) over 1660.36 were more prone to severe acute pancreatitis (SAP). The SII, indicative of acute inflammation, can help predict clinical outcomes for AP patients admitted to the emergency department.

Anahtar Kelimeler

pancreatitis SII systemic Immuno-inflammation index

Kaynakça

  • Vege S, Yadav D, Chari S. Pancreatitis. GI Epidemiology, Talley NJ, Locke GR, Saito YA. Blackwell Publishing, Malden, MA; 2007.
  • Bogan BD, McGuire SP, Maatman TK. Readmission in acute pancreatitis: Etiology, risk factors, and opportunities for improvement. Surgery Open Science. 2022;10:232-7. doi: 10.1016/j.sopen.2022.10.010. PubMed PMID: S2589845022000719.
  • Banks PA, Freeman ML, Gastroenterology PPCotACoGJOjotACo, ACG. Practice guidelines in acute pancreatitis. 2006;101(10):2379-400.
  • Pandol SJ, Saluja AK, Imrie CW, Banks PAJG. Acute pancreatitis: bench to the bedside. 2007;133(3):1056. e1-. e25.
  • Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-11. Epub 2012/10/27. doi: 10.1136/gutjnl-2012-302779. PubMed PMID: 23100216.
  • Yang CJ, Chen J, Phillips AR, Windsor JA, Petrov MS. Predictors of severe and critical acute pancreatitis: a systematic review. Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver. 2014;46(5):446-51. Epub 2014/03/22. doi: 10.1016/j.dld.2014.01.158. PubMed PMID: 24646880.
  • Feng JF, Chen S, Yang X. Systemic immune-inflammation index (SII) is a useful prognostic indicator for patients with squamous cell carcinoma of the esophagus. Medicine. 2017;96(4):e5886. Epub 2017/01/26. doi: 10.1097/md.0000000000005886. PubMed PMID: 28121932; PubMed Central PMCID: PMCPMC5287956.
  • Hong X, Cui B, Wang M, Yang Z, Wang L, Xu Q. Systemic Immune-inflammation Index, Based on Platelet Counts and Neutrophil-Lymphocyte Ratio, Is Useful for Predicting Prognosis in Small Cell Lung Cancer. The Tohoku journal of experimental medicine. 2015;236(4):297-304. Epub 2015/08/08. doi: 10.1620/tjem.236.297. PubMed PMID: 26250537.
  • Lolli C, Caffo O, Scarpi E, et al. Systemic Immune-Inflammation Index Predicts the Clinical Outcome in Patients with mCRPC Treated with Abiraterone. Frontiers in pharmacology. 2016;7:376. Epub 2016/10/30. doi: 10.3389/fphar.2016.00376. PubMed PMID: 27790145; PubMed Central PMCID: PMCPMC5062111.
  • Lolli C, Basso U, Derosa L, et al. Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib. Oncotarget. 2016;7(34):54564-71. Epub 2016/07/14. doi: 10.18632/oncotarget.10515. PubMed PMID: 27409344; PubMed Central PMCID: PMCPMC5342364.
  • Liu X, Guan G, Cui X, Liu Y, Liu Y, Luo F. Systemic Immune-Inflammation Index (SII) Can Be an Early Indicator for Predicting the Severity of Acute Pancreatitis: A Retrospective Study. International journal of general medicine. 2021;14:9483-9. Epub 2021/12/25. doi: 10.2147/ijgm.S343110. PubMed PMID: 34949937; PubMed Central PMCID: PMCPMC8689009.
  • Kaplan M, Ates I, Oztas E, et al. A New Marker to Determine Prognosis of Acute Pancreatitis: PLR and NLR Combination. Journal of medical biochemistry. 2018;37(1):21-30. Epub 2018/12/26. doi: 10.1515/jomb-2017-0039. PubMed PMID: 30581338; PubMed Central PMCID: PMCPMC6294107.
  • Hu B, Yang XR, Xu Y, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clinical cancer research : an official journal of the American Association for Cancer Research. 2014;20(23):6212-22. Epub 2014/10/02. doi: 10.1158/1078-0432.Ccr-14-0442. PubMed PMID: 25271081.
  • Werner J, Feuerbach S, Uhl W, Büchler MW. Management of acute pancreatitis: from surgery to interventional intensive care. Gut. 2005;54(3):426-36. Epub 2005/02/16. doi: 10.1136/gut.2003.035907. PubMed PMID: 15710995; PubMed Central PMCID: PMCPMC1774421.
  • Zerem E. Treatment of severe acute pancreatitis and its complications. World journal of gastroenterology. 2014;20(38):13879-92. Epub 2014/10/17. doi: 10.3748/wjg.v20.i38.13879. PubMed PMID: 25320523; PubMed Central PMCID: PMCPMC4194569.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Genel Cerrahi, Gastroenteroloji ve Hepatoloji
Bölüm Araştırma Makalesi
Yazarlar

Şener Balas

Nurhak Cihangir Çınkıl

Muhammed Apaydın

Yayımlanma Tarihi 30 Eylül 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 14 Sayı: 3

Kaynak Göster

APA Balas, Ş., Çınkıl, N. C., & Apaydın, M. (2023). Şiddetli pankreatiti öngörmede yeni biyobelirteç; Sistemik immün-inflamasyon indeksi. Turkish Journal of Clinics and Laboratory, 14(3), 464-469. https://doi.org/10.18663/tjcl.1333413
AMA Balas Ş, Çınkıl NC, Apaydın M. Şiddetli pankreatiti öngörmede yeni biyobelirteç; Sistemik immün-inflamasyon indeksi. TJCL. Eylül 2023;14(3):464-469. doi:10.18663/tjcl.1333413
Chicago Balas, Şener, Nurhak Cihangir Çınkıl, ve Muhammed Apaydın. “Şiddetli Pankreatiti öngörmede Yeni biyobelirteç; Sistemik immün-Inflamasyon Indeksi”. Turkish Journal of Clinics and Laboratory 14, sy. 3 (Eylül 2023): 464-69. https://doi.org/10.18663/tjcl.1333413.
EndNote Balas Ş, Çınkıl NC, Apaydın M (01 Eylül 2023) Şiddetli pankreatiti öngörmede yeni biyobelirteç; Sistemik immün-inflamasyon indeksi. Turkish Journal of Clinics and Laboratory 14 3 464–469.
IEEE Ş. Balas, N. C. Çınkıl, ve M. Apaydın, “Şiddetli pankreatiti öngörmede yeni biyobelirteç; Sistemik immün-inflamasyon indeksi”, TJCL, c. 14, sy. 3, ss. 464–469, 2023, doi: 10.18663/tjcl.1333413.
ISNAD Balas, Şener vd. “Şiddetli Pankreatiti öngörmede Yeni biyobelirteç; Sistemik immün-Inflamasyon Indeksi”. Turkish Journal of Clinics and Laboratory 14/3 (Eylül 2023), 464-469. https://doi.org/10.18663/tjcl.1333413.
JAMA Balas Ş, Çınkıl NC, Apaydın M. Şiddetli pankreatiti öngörmede yeni biyobelirteç; Sistemik immün-inflamasyon indeksi. TJCL. 2023;14:464–469.
MLA Balas, Şener vd. “Şiddetli Pankreatiti öngörmede Yeni biyobelirteç; Sistemik immün-Inflamasyon Indeksi”. Turkish Journal of Clinics and Laboratory, c. 14, sy. 3, 2023, ss. 464-9, doi:10.18663/tjcl.1333413.
Vancouver Balas Ş, Çınkıl NC, Apaydın M. Şiddetli pankreatiti öngörmede yeni biyobelirteç; Sistemik immün-inflamasyon indeksi. TJCL. 2023;14(3):464-9.
 Kapak Resmi İndir


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