Prediction of the severity of acute pancreatitis on admission by urinary trypsinogen activation peptide: a meta-analysis.

Abstract

AIM:

To undertake a meta-analysis on the value of urinary trypsinogen activation peptide (uTAP) in predicting severity of acute pancreatitis on admission.

METHODS:

Major databases including Medline, Embase, Science Citation Index Expanded and the Cochrane Central Register of Controlled Trials in the Cochrane Library were searched to identify all relevant studies from January 1990 to January 2013. Pooled sensitivity, specificity and the diagnostic odds ratios (DORs) with 95%CI were calculated for each study and were compared to other systems/biomarkers if mentioned within the same study. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated.

RESULTS:

In total, six studies of uTAP with a cut-off value of 35 nmol/L were included in this meta-analysis. Overall, the pooled sensitivity and specificity of uTAP for predicting severity of acute pancreatitis, at time of admission, was 71% and 75%, respectively (AUC = 0.83, DOR = 8.67, 95%CI: 3.70-20.33). When uTAP was compared with plasma C-reactive protein, the pooled sensitivity, specificity, AUC and DOR were 0.64 vs 0.67, 0.77 vs 0.75, 0.82 vs 0.79 and 6.27 vs 6.32, respectively. Similarly, the pooled sensitivity, specificity, AUC and DOR of uTAP vs Acute Physiology and Chronic Health Evaluation II within the first 48 h of admission were found to be 0.64 vs 0.69, 0.77 vs 0.61, 0.82 vs 0.73 and 6.27 vs 4.61, respectively.

CONCLUSION:

uTAP has the potential to act as a stratification marker on admission for differentiating disease severity of acute pancreatitis.

• Authors: Wei Huang, Kiran Altaf, Tao Jin, Jun-Jie Xiong, Li Wen, Muhammad A Javed, Marianne Johnstone, Ping Xue, Christopher M Halloran, Qing Xia
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 19 Issue 28 Pg. 4607-15 (Jul 28 2013) ISSN: 2219-2840 [Electronic] United States
• PMID: 23901239 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Biomarkers
• Oligopeptides
• trypsinogen activation peptide

Topics

• Acute Disease
• Adult
• Aged
• Aged, 80 and over
• Biomarkers (urine)
• Female
• Humans
• Male
• Middle Aged
• Odds Ratio
• Oligopeptides (urine)
• Pancreatitis (diagnosis, urine)
• Patient Admission
• Predictive Value of Tests
• Prognosis
• Severity of Illness Index