Epigenetic changes mediated by the polycomb repressor complex 1 in acinar-to-ductal metaplasia and pancreatic carcinogenesis.

Abstract

Background: Clinical assessment of patients with acute pancreatitis(AP) remains unsolved problem in modern emergency surgery. Aims: To investigate the dynamic variance of HLA DR, HLA DR bright, CD14+/CD4+, CD14+/CD16-, CD14+/CD16+ and CD14+/CD56+ expression on monocytes and their role as predictors of severity, local and systemic complications in patients with AP Patients & methods: 50 patients with AP were admitted into Department of Surgery of University Hospital Stara Zagora from December 1, 2012 to January 31, 2014. Markers of monocytes expression at admission, 48th hour and 5th day of hospitalization was detected with flow cytometry analysis to determine whether a prediction could be made in regards of severity and to development of local and systemic complication. Results: 27 (54%) had mild AP, 17 (34%) moderate AP and 6 (12%) severe disease. 12 (24%) patients developed organ failure and 23(46%) local complications. HLA-DR and HLA DR bright expression on the 48th hour were significant lower in the patients with moderate and severe AP (p0,002, p-0,001 ANOVA), in presence of organ failure (p-0,048, p-0,047 ANOVA) and local complications (p-0,002, p-0,001 ANOVA). We found a correlation between CD14+/CD16+ levels(48thh.) and severity, systemic and local complications (p<0.005 ANOVA). Conclusion: The determination of levels of HLA DR, HLA DR bright and CD14+/CD16+ (48th h.) are effective and useful predictors, with high correlation with severity, local and systemic complications and would determine initiation of therapeutic approach associated with Ð better outcome. Abstracts / Pancreatol S64