Predictive value of C-reactive protein and procalcitonin in the early forecasting acute pancreatitis based on the new Atlanta classification criteria

Abstract

Objective Based on the 2012 Atlanta classification criteria, to study the value of C-reactive protein (CRP) and procalcitonin (PCT) in the early forecasting acute pancreatitis (AP). Methods Eighty-three patients with AP were selected. The patients were divided into mild AP (MAP) group (39 cases), moderately severe AP (MSAP) group (31 cases) and severe AP (SAP) group (13 cases) according to the 2012 Atlanta classification criteria. Twenty-seven healthy people were selected as control group. The levels of serum CRP and PCT were measured. The predictive value of serum CRP and PCT levels for SAP, infectious pancreatic necrosis (IPN), organ failure and death risk was assessed using the area under the curve (AUC). Results The serum CRP and PCT levels in MAP group, MSAP group and SAP group were significantly higher than those in control group: (49.84 ± 12.26), (89.77 ± 22.10) and (123.69 ± 37.09) mg/L vs. (3.92 ± 1.37) mg/L, (1.15 ± 0.42), (2.44 ± 0.61) and (3.27 ± 0.96) μg/L vs. (0.41 ± 0.13) μg/L, and those in MSAP group and SAP group were significantly higher than those in MAP group, those in SAP group were significantly higher than those in MSAP group, and there were statistical differences (P<0.05). The Spearman correlation analysis result showed that AP severity was positively correlated with serum CRP and PCT levels (r= 0.652 and 0.714, P<0.05). The accuracy of serum CRP level for forecasting SAP and IPN was medium (AUC= 0.73 and 0.76), and for forecasting organ failure accuracy was low (AUC= 0.67). Serum CRP showed no significance in forecasting death risk (AUC= 0.46). The accuracy of serum PCT level for forecasting SAP, IPN and death risk accuracy was medium (AUC= 0.71, 0.86 and 0.80), and for forecasting organ failure accuracy was low (AUC= 0.64). Conclusions Based on the 2012 Atlanta classification criteria, the accuracy of serum CRP level for forecasting SAP is higher than that of serum PCT level, the accuracy of serum PCT level for forecasting IPN and death risk is higher than that of serum CRP level, and accuracy of serum CRP and PCT levels for forecasting organ failure are low. Key words: Pancreatitis; C-reactive protein; Calcitonin; Retrospective studies