Kumar Shishir, Aziz Tarique, Kumar Rajendra, Kumar Pramod, Kumar Amit, Saha Avijit, Kumar Divakar, Niraj Mukesh Kumar
Department of Biochemistry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Department of Physiology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
J Family Med Prim Care. 2025 Feb;14(2):667-674. doi: 10.4103/jfmpc.jfmpc_1366_24. Epub 2025 Feb 21.
Acute pancreatitis (AP) is an inflammatory disease of the pancreas with varying severity. The mortality rate varies from 20% to 40% among severe acute pancreatitis (SAP). Interleukin-6 (IL-6) is a pro- and anti-inflammatory cytokine that involves various infections, inflammations, and systemic disorders. Injury to acinar cells leads to necrosis, releasing proinflammatory cytokines, including IL-6, which peaks earlier. The lack of extensive data regarding the association of IL-6 with AP influences us to do this meta-analysis for early detection and treatment of AP to prevent multiorgan failure.
We searched the PubMed, Cochrane Library, and Google Scholar databases for relevant articles published from inception to June 2024. We examined the positive and negative likelihood ratios, diagnostic odds ratios, and pooled sensitivity and specificity. We used the QUADAS-2 tool to evaluate the risk of bias.
This meta-analysis included 13 studies involving 1386 patients with AP, of which 343 had SAP and 1043 had mild and moderately severe AP. The positive and negative likelihood ratios were 3.5 (95% CI 2.6 to 4.5) and 0.25 (95% CI 0.16 to 0.40). The diagnostic odds ratio of IL-6 to diagnose SAP is 14 (95% CI: 7 to 27), and the summary receiver operating characteristic curve is 0.85 (95% CI: 0.82-0.88).
Based on the results of this meta-analysis, serum IL-6 is a promising biomarker for diagnosing SAP in the early stage. However, a larger-scale study involving a more extensive population is necessary due to the considerable variation between the studies.
急性胰腺炎（AP）是一种严重程度各异的胰腺炎症性疾病。在重症急性胰腺炎（SAP）中，死亡率在20%至40%之间。白细胞介素-6（IL-6）是一种促炎和抗炎细胞因子，涉及各种感染、炎症和全身性疾病。腺泡细胞损伤会导致坏死，释放包括IL-6在内的促炎细胞因子，IL-6峰值出现较早。关于IL-6与AP关联的广泛数据缺乏，促使我们进行这项荟萃分析，以早期检测和治疗AP，预防多器官功能衰竭。
我们在PubMed、Cochrane图书馆和谷歌学术数据库中搜索了从创刊到2024年6月发表的相关文章。我们检查了阳性和阴性似然比、诊断比值比以及合并敏感性和特异性。我们使用QUADAS-2工具评估偏倚风险。
这项荟萃分析纳入了13项研究，涉及1386例AP患者，其中343例为SAP，1043例为轻度和中度重症AP。阳性和阴性似然比分别为3.5（95%可信区间2.6至4.5）和0.25（95%可信区间0.16至0.40）。IL-6诊断SAP的诊断比值比为14（95%可信区间：7至27），汇总受试者工作特征曲线为0.85（95%可信区间：0.82 - 0.88）。
基于这项荟萃分析的结果，血清IL-6是早期诊断SAP的一种有前景的生物标志物。然而，由于各研究之间存在相当大的差异，有必要开展涉及更广泛人群的更大规模研究。
