Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 28, 2012; 18(20): 2554-2560
Published online May 28, 2012. doi: 10.3748/wjg.v18.i20.2554
Serum inter-cellular adhesion molecule 1 is an early marker of diagnosis and prediction of severe acute pancreatitis
Hai-Hang Zhu, Lin-Lin Jiang
Hai-Hang Zhu, Lin-Lin Jiang, Department of Gastroenterology, Northern Jiangsu Hospital, College of Clinical Medical Medicine, Yangzhou University, Yangzhou 225001, Jiangsu Province, China
Author contributions: Zhu HH designed the research, analyzed the data and wrote the paper; Jiang LL performed the research.
Correspondence to: Hai-Hang Zhu, Chief, Professor of Medicine, Department of Gastroenterology, Northern Jiangsu Hospital, College of Clinical Medicine, Yangzhou University, 98 West Nantong Road, Yangzhou 225001, Jiangsu Province, China. zhuhaihang@medmail.com.cn
Telephone: +86-514-87937475 Fax: +86-514-87937406
Received: August 2, 2011
Revised: September 28, 2011
Accepted: February 16, 2012
Published online: May 28, 2012
Abstract

AIM: To determine if serum inter-cellular adhesion molecule 1 (ICAM-1) is an early marker of the diagnosis and prediction of severe acute pancreatitis (SAP) within 24 h of onset of pain, and to compare the sensitivity, specificity and prognostic value of this test with those of acute physiology and chronic health evaluation (APACHE) II score and interleukin-6 (IL-6).

METHODS: Patients with acute pancreatitis (AP) were divided into two groups according to the Ranson’s criteria: mild acute pancreatitis (MAP) group and SAP group. Serum ICAM-1, APACHE IIand IL-6 levels were detected in all the patients. The sensitivity, specificity and prognostic value of the ICAM-1, APACHE IIscore and IL-6 were evaluated.

RESULTS: The ICAM-1 level in 36 patients with SAP within 24 h of onset of pain was increased and was significantly higher than that in the 50 patients with MAP and the 15 healthy volunteers (P < 0.01). The ICAM-1 level (25 ng/mL) was chosen as the optimum cutoff to distinguish SAP from MAP, and the sensitivity, specificity, positive predictive value, negative predictive value (NPV), positive likelihood ratio and negative likelihood ratio were 61.11%, 71.42%, 0.6111, 0.7142, 2.1382 and 0.5445, respectively. The area under the curve demonstrated that the prognostic accuracy of ICAM-1 (0.712) was similar to the APACHE-IIscoring system (0.770) and superior to IL-6 (0.508) in distinguishing SAP from MAP.

CONCLUSION: ICAM-1 test is a simple, rapid and reliable method in clinical practice. It is an early marker of diagnosis and prediction of SAP within the first 24 h after onset of pain or on admission. As it has a relatively low NPV and does not allow it to be a stand-alone test for the diagnosis of AP, other conventional diagnostic tests are required.

Keywords: Intercellular adhesion molecule-1; Severe acute pancreatitis; Early prediction