Diagnostic Accuracy of Interleukin-6 and Interleukin-8 in Predicting Severe Acute Pancreatitis: A Meta-Analysis
Diagnostic Accuracy of Interleukin-6 and Interleukin-8 in Predicting Severe Acute Pancreatitis: A Meta-Analysis
复制标题
DOI：
10.1159/000214191
复制
发表时间：
2009-01-01
期刊：
影响因子：
3.6
通讯作者：
Papachristou, Georgios I.
中科院分区：
文献类型：
--
作者：
Aoun, Elie;Chen, Joy;Papachristou, Georgios I.
目的：早期识别重症急性胰腺炎（SAP）患者的风险至关重要。已经评估了疾病严重程度的血清标志物，包括白细胞介素（IL）-6和IL-8;然而，它们的预测准确性在不同研究中存在显著差异。我们进行了一项荟萃分析，以评估IL-6和IL-8预测SAP的准确性。研究方法：我们确定了相关的已发表文章，并使用随机效应模型计算了合并的敏感性、特异性和似然比。我们纳入了IL-6第1、2和3天的值以及IL-8第1和2天的值。我们还构建了受试者工作曲线，并评估了曲线下面积（AUC）和诊断比值比（DORs）作为诊断准确性的指标。结果：对于IL-6，我们纳入了第1天的7份报告和第2天和第3天的4份报告。对于IL-8，我们分析了第1天的5项研究和第2天的4项研究。合并的IL-6敏感性范围在81.0和83.6%之间，特异性范围在75.6和85.3%之间，第1、2和3天的阳性似然比分别为3.43、4.90和4.40。第1天和第2天的IL-8合并灵敏度分别为65.8%和70.9%，特异性分别为66.5%和91.3%，阳性似然比分别为1.96和8.15。第1、2和3天的IL-6 AUC分别为0.75、0.88和0.85。第1天和第2天的IL-8 AUC分别为0.73和0.91。在第1天，IL-6的DOR高于IL-8。结论：IL-6和IL-8在预测SAP中的作用是可以接受的。需要更大规模的验证性研究，正式比较这种性能与更常用的标记物。版权所有（C）2010 S. Karger AG、巴塞尔和IAP
Objectives: The early identification of patients at risk for severe acute pancreatitis (SAP) is crucial. Serum markers of disease severity have been assessed including interleukin (IL)-6 and IL-8; however, their predictive accuracy has varied significantly across studies. We conducted a meta-analysis to assess the accuracy of IL-6 and IL-8 at predicting SAP. Methods: We identified relevant published articles and calculated pooled sensitivities, specificities and likelihood ratios using the random-effect model. We included values for days 1, 2 and 3 of presentation for IL-6 and for days 1 and 2 for IL-8. We also constructed summary receiver-operating curves and assessed the area under the curve (AUC) and the diagnostic odds ratios (DORs) as measures of diagnostic accuracy. Results: For IL-6, we included 7 reports for day 1 and 4 reports for days 2 and 3. For IL-8, we analyzed 5 studies for day 1 and 4 for day 2. The pooled IL-6 sensitivities ranged between 81.0 and 83.6% and specificities between 75.6 and 85.3% with positive likelihood ratios of 3.43, 4.90 and 4.40 for days 1, 2 and 3, respectively. The IL-8 pooled sensitivities were 65.8 and 70.9% with specificities of 66.5 and 91.3% for days 1 and 2 with positive likelihood ratios of 1.96 and 8.15. The IL-6 AUCs were 0.75, 0.88 and 0.85 for days 1, 2 and 3. The IL-8 AUCs were 0.73 and 0.91 for days 1 and 2. The DOR for IL-6 was higher than that of IL-8 on day 1. Conclusion: IL-6 and IL-8 seem to perform at an acceptable level in predicting SAP. Larger confirmatory studies formally comparing this performance with that of more commonly used markers are needed. Copyright (C) 2010 S. Karger AG, Basel and IAP