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通过分析血清糖蛋白 2 进行重症急性胰腺炎的血清学诊断和预后判断。

Serological diagnosis and prognosis of severe acute pancreatitis by analysis of serum glycoprotein 2.

机构信息

Institute of Biotechnology, Faculty of Environment and Natural Sciences, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg.

Institute of Molecular and Clinical Immunology, Otto-von-Guericke University, Magdeburg.

出版信息

Clin Chem Lab Med. 2017 May 1;55(6):854-864. doi: 10.1515/cclm-2016-0797.

DOI:10.1515/cclm-2016-0797

PMID:27837595

Abstract

BACKGROUND

Glycoprotein 2 (GP2), the pancreatic major zymogen granule membrane glycoprotein, was reported to be elevated in acute pancreatitis in animal models.

METHODS

Enzyme-linked immunosorbent assays (ELISAs) were developed to evaluate human glycoprotein 2 isoform alpha (GP2a) and total GP2 (GP2t) as specific markers for acute pancreatitis in sera of 153 patients with acute pancreatitis, 26 with chronic pancreatitis, 125 with pancreatic neoplasms, 324 with non-pancreatic neoplasms, 109 patients with liver/biliary disease, 67 with gastrointestinal disease, and 101 healthy subjects. GP2a and GP2t levels were correlated with procalcitonin and C-reactive protein in 152 and 146 follow-up samples of acute pancreatitis patients, respectively.

RESULTS

The GP2a ELISA revealed a significantly higher assay accuracy in contrast to the GP2t assay (sensitivity ≤3 disease days: 91.7%, specificity: 96.7%, positive likelihood ratio [LR+]: 24.6, LR-: 0.09). GP2a and GP2t levels as well as prevalences were significantly elevated in early acute pancreatitis (≤3 disease days) compared to all control cohorts (p<0.05, respectively). GP2a and GP2t levels were significantly higher in patients with severe acute pancreatitis at admission compared with mild cases (p<0.05, respectively). Odds ratio for GP2a regarding mild vs. severe acute pancreatitis with lethal outcome was 7.8 on admission (p=0.0222). GP2a and GP2t levels were significantly correlated with procalcitonin [Spearman's rank coefficient of correlation (ρ)=0.21, 0.26; p=0.0110, 0.0012; respectively] and C-reactive protein (ρ=0.37, 0.40; p<0.0001; respectively).

CONCLUSIONS

Serum GP2a is a specific marker of acute pancreatitis and analysis of GP2a can aid in the differential diagnosis of acute upper abdominal pain and prognosis of severe acute pancreatitis.

摘要

背景

糖蛋白 2（GP2）是胰腺主要酶原颗粒膜糖蛋白，据报道在动物模型的急性胰腺炎中升高。

方法

建立酶联免疫吸附试验（ELISA）来评估人糖蛋白 2 同工型α（GP2a）和总 GP2（GP2t）作为急性胰腺炎患者血清中的特异性标志物，这些患者共 153 例（急性胰腺炎 153 例，慢性胰腺炎 26 例，胰腺肿瘤 125 例，非胰腺肿瘤 324 例，肝脏/胆道疾病 109 例，胃肠道疾病 67 例，健康受试者 101 例）。在 152 例和 146 例急性胰腺炎患者的随访样本中，分别将 GP2a 和 GP2t 水平与降钙素原和 C 反应蛋白进行了相关性分析。

结果

与 GP2t 检测相比，GP2a ELISA 显示出更高的检测准确性（≤3 天疾病：敏感性 91.7%，特异性 96.7%，阳性似然比 [LR+]：24.6，LR-：0.09）。与所有对照组相比，GP2a 和 GP2t 水平及患病率在早期急性胰腺炎（≤3 天）中显著升高（分别为 p<0.05）。与轻度病例相比，入院时重症急性胰腺炎患者的 GP2a 和 GP2t 水平显著升高（分别为 p<0.05）。入院时，GP2a 对轻度 vs. 重症胰腺炎伴致死结局的比值比为 7.8（p=0.0222）。GP2a 和 GP2t 水平与降钙素原呈显著正相关（Spearman 秩相关系数 ρ=0.21，0.26；p=0.0110，0.0012；分别），与 C 反应蛋白呈显著正相关（ρ=0.37，0.40；p<0.0001；分别）。