Ramirez-Gonzalez Luis Ricardo, Ordonez-Forestiery Leonardo Rafael, Garcia Andrea, Iniguez-Martin-Del-Campo Maximiliano Cesar, Llamas-Hernandez Francia Damary, Morfin-Meza Kathia Dayana, Gonzalez-Munoz Samantha Emily, Capetillo-Texson Carlos Enrique, Gomez-Sierra Jose Pablo, Suarez-Carreon Luis Osvaldo, Cervantes-Guevara Gabino, Cervantes-Perez Enrique, Ramirez-Ochoa Sol, Alvarez-Villasenor Andrea Socorro, Cortes-Flores Ana Olivia, Gonzalez-Ojeda Alejandro, Fuentes-Orozco Clotilde
Department of General Surgery, Specialty Hospital, Western National Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico.
Biomedical Research Unit 02, Specialty Hospital, Western National Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, Mexico.
Gastroenterology Res. 2025 Apr;18(2):56-62. doi: 10.14740/gr2029. Epub 2025 Apr 20.
Acute pancreatitis (AP) is a severe inflammatory disorder that begins with the inappropriate activation of pancreatic enzymes within acinar cells due to biliary reflux, alcohol abuse, gallstones, and autoimmune disease. Several biomarkers have been studied that may aid in the early detection of pancreatic necrosis. The aim of this project was to evaluate the usefulness of procalcitonin (PCT) in predicting mortality in patients with severe AP in Mexican population.
An observational study, including 59 patients diagnosed with AP from 2018 to 2023, was conducted in a tertiary care hospital. Serum PCT levels were assessed on the first and third days of hospitalization (24 and 72 h).
A total of 59 patients were included, and the main etiologies were lithiasis (28 patients, 47.5%) and endoscopic retrograde cholangiopancreatography (ERCP) (nine patients, 15.3%). Of the total patients, 16 (27.1%) died during their hospital stay, and the main etiologies were septic shock of abdominal origin (10 patients, 62.5%) followed by extra-abdominal shock (six patients, 37.5%). The average PCT level was 4.54 ± 8.12 on the first day of hospital stay, and 5.20 ± 10.90 at 72 h. The cut-off point was 1.26 ng/mL with the best sensitivity and specificity of PCT as a predictor of mortality at 72 h of 75% and 68%, respectively (area under the curve 0.7, 95% confidence interval (CI): 0.61 - 0.88), and positive and negative predictive values of 0.46 and 0.87, respectively.
We propose the usefulness of PCT as a biochemical marker to predict mortality in patients with severe AP due to its accessibility in the hospital environment. We propose to carry out studies with more patients and follow-up times. In addition, it is necessary to consider other biomarkers associated with PCT to help us improve the positive predictive value of mortality in this disease.
急性胰腺炎（AP）是一种严重的炎症性疾病，由于胆汁反流、酗酒、胆结石和自身免疫性疾病等原因，腺泡细胞内的胰腺酶被不适当激活而引发。已经对几种生物标志物进行了研究，它们可能有助于早期发现胰腺坏死。本项目的目的是评估降钙素原（PCT）在预测墨西哥人群中重症AP患者死亡率方面的实用性。
在一家三级护理医院进行了一项观察性研究，纳入了2018年至2023年期间诊断为AP的59例患者。在住院的第一天和第三天（24小时和72小时）评估血清PCT水平。
共纳入59例患者，主要病因是结石（28例，47.5%）和内镜逆行胰胆管造影术（ERCP）（9例，15.3%）。在所有患者中，16例（27.1%）在住院期间死亡，主要病因是腹部源性感染性休克（10例，62.5%），其次是腹部外休克（6例，37.5%）。住院第一天的平均PCT水平为4.54±8.12，72小时时为5.20±10.90。截断点为1.26 ng/mL，PCT作为72小时死亡率预测指标的最佳敏感性和特异性分别为75%和68%（曲线下面积0.7，95%置信区间（CI）：0.61 - 0.88），阳性预测值和阴性预测值分别为0.46和0.87。
我们提出PCT作为一种生化标志物，因其在医院环境中易于获取，可用于预测重症AP患者的死亡率。我们建议开展更多患者和更长随访时间的研究。此外，有必要考虑与PCT相关的其他生物标志物，以帮助我们提高该疾病死亡率的阳性预测值。
