Serum interleukin-6, tumor necrosis factor alpha and C-reactive protein in early prediction of severity of acute pancreatitis.

It has been discussed that cytokine determination is a simple, cheap and accurate way to predict the severity of the acute pancreatitis. In this study, the usefulness of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha) and C-reactive protein (CRP) to assess the prognosis of acute pancreatitis was evaluated.Blood tests for the IL-6, TNF-alpha and CRP in patients with acute pancreatitis on the 1st, 2nd, 3rd, and 7th hospital days were performed. Patients were divided into severe and mild disease groups according to the Atlanta criteria, and the sensitivity, specificity and diagnostic accuracy of the serum concentrations of these 3 markers were compared.Thirty-three patients with acute pancreatitis admitted to our hospital between January 2002 to March 2003 were studied, 19 mild-group patients and 14 severe-group. Serum concentrations of IL-6 and CRP were highly significantly different (p < 0.005) between the severe group and the mild group on the day of admission and on the 2nd, 3rd and 7th days. TNF-alpha only had a significant difference (p < 0.05) in these 2 groups on the first 2 days. IL-6 and TNF-alpha had a peak value on the 1st day of admission, while CRP reached peak value on the 2nd hospital day. On day 1, IL-6 had a highest sensitivity (100%) specificity (89.7%) and accuracy (91%) among these 3 markers. On day 2, CRP had a relatively higher value in sensitivity (83.3%) and accuracy (80.0%).The serum concentration of IL-6 on the first day and/or the serum concentration of CRP on the 2nd day of admission are useful for early prediction of the severity of acute pancreatitis.