Sichuan Provincial Pancreatitis Center, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World J Gastroenterol. 2013 Jul 28;19(28):4607-15. doi: 10.3748/wjg.v19.i28.4607.
To undertake a meta-analysis on the value of urinary trypsinogen activation peptide (uTAP) in predicting severity of acute pancreatitis on admission.
Major databases including Medline, Embase, Science Citation Index Expanded and the Cochrane Central Register of Controlled Trials in the Cochrane Library were searched to identify all relevant studies from January 1990 to January 2013. Pooled sensitivity, specificity and the diagnostic odds ratios (DORs) with 95%CI were calculated for each study and were compared to other systems/biomarkers if mentioned within the same study. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated.
In total, six studies of uTAP with a cut-off value of 35 nmol/L were included in this meta-analysis. Overall, the pooled sensitivity and specificity of uTAP for predicting severity of acute pancreatitis, at time of admission, was 71% and 75%, respectively (AUC = 0.83, DOR = 8.67, 95%CI: 3.70-20.33). When uTAP was compared with plasma C-reactive protein, the pooled sensitivity, specificity, AUC and DOR were 0.64 vs 0.67, 0.77 vs 0.75, 0.82 vs 0.79 and 6.27 vs 6.32, respectively. Similarly, the pooled sensitivity, specificity, AUC and DOR of uTAP vs Acute Physiology and Chronic Health Evaluation II within the first 48 h of admission were found to be 0.64 vs 0.69, 0.77 vs 0.61, 0.82 vs 0.73 and 6.27 vs 4.61, respectively.
uTAP has the potential to act as a stratification marker on admission for differentiating disease severity of acute pancreatitis.
对尿胰蛋白酶原激活肽（uTAP）在预测入院时急性胰腺炎严重程度方面的价值进行荟萃分析。
检索 Medline、Embase、科学引文索引扩展版和 Cochrane 图书馆 Cochrane 对照试验中心等主要数据库，以确定从 1990 年 1 月至 2013 年 1 月的所有相关研究。计算每个研究的汇总敏感性、特异性和诊断比值比（DOR）及其 95%CI，如果同一研究中提到其他系统/生物标志物，则将其与其他系统/生物标志物进行比较。绘制汇总受试者工作特征曲线并评估曲线下面积（AUC）。
本荟萃分析共纳入了 6 项关于 uTAP 截断值为 35 nmol/L 的研究。总体而言，uTAP 在预测入院时急性胰腺炎严重程度方面的汇总敏感性和特异性分别为 71%和 75%（AUC=0.83，DOR=8.67，95%CI：3.70-20.33）。当 uTAP 与血浆 C 反应蛋白进行比较时，汇总敏感性、特异性、AUC 和 DOR 分别为 0.64 比 0.67，0.77 比 0.75，0.82 比 0.79 和 6.27 比 6.32。同样，在入院后 48 小时内 uTAP 与急性生理学和慢性健康评估 II 的汇总敏感性、特异性、AUC 和 DOR 分别为 0.64 比 0.69，0.77 比 0.61，0.82 比 0.73 和 6.27 比 4.61。
uTAP 有望成为入院时区分急性胰腺炎严重程度的分层标志物。
