The diagnostic values of endothelial cell specific molecule-1, procalcitonin, C reactive protein, interleukin-6 in patients with sepsis

Abstract

Objective To evaluate the diagnostic values of endothelial cell specific molecule-1 (ESM-1), procalcitonin (PCT), C reactive protein (CRP), interleukin-6 (IL-6) in patients with sepsis. Methods This study totally enrolled 90 patients who were admitted to our hospital from July 2014 to February 2016 were divided into sepsis group (n=32), and common infection group (n=58). Serum levels of ESM-1 were detected by enzyme-linked immunosorbent assay (ELISA); The levels of PCT and IL-6 were measured by automatic electrochemiluminescene (ECL) analyzer; The levels of CRP were measured by rate immunonephelometric analyzer. The diagnostic powers of this four biomarkers were constructed by receiver operating characteristic (ROC) curve. Results The values of ESM-1, PCT, IL-6 and CRP in sepsis group were 3.93 ng/ml, 4.05 ng/ml, 83.20 mg/L, 61.80 ng/L, respectively; The values of ESM-1, PCT, IL-6 and CRP in common infection group were 0.69 ng/ml, 0.41 ng/ml, 64.35 mg/L, 17.20 ng/L, respectively; P=0.001, 0.001, 0.003, 0.001, respectively; there were statistically significant differences. The area under the ROC curve (AUC) of ESM-1, PCT, CRP, IL-6 were 0.911, 0.893, 0.667, 0.760; The AUC of ESM-1 was higer than that of CRP (P=0.001); The AUC of ESM-1 was higer than that of IL-6 (P=0.003); The AUC of PCT was higer than that of CRP (P=0.001); The AUC of PCT was higer than that of IL-6 (P=0.002); There was no significant difference in ESM-1 and the PCT. As an early diagnostic indicator of sepsis, the cut-off value of ESM-1 was 2.215 ng/ml, with sensitivity of 81.3%, specificity of 93.1%, Youden index was 0.744, positive predictive value was 0.867, negative predictive value was 0.900, positive likelihood ratio was 11.781, negative likelihood ratio was 0.201. As an early diagnostic indicator of sepsis, the cut-off value of PCT was 1.875 ng/ml, with sensitivity of 84.4%, specificity of 82.8%, Youden index was 0.672, positive predictive value was 0.730, negative predictive value was 0.906, positive likelihood ratio was 4.894, negative likelihood ratio was 0.189. Conclusion ESM-1, PCT as early biomarkers for sepsis are superior to CRP, IL-6, both have high value for the early diagnosis of the patients with sepsis. Key words: Endothelial cell specific molecule-1; Procalcitonin; C reactive protein; Interleukin-6; Sepsis