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The Value of Infectious Biomarkers for Prediction of Complication after Pancreatic Surgery
( Yuan Fang ),( Gang Jin ),( Xubao Liu ),( Yajin Chen ),( Bei Sun ),( Zhongtao Zhang ),( Wenchuan Wu ),( Wenhui Lou ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: To assess the predictive value of biomarkers for early complication after pancreatic surgery. Methods: 950 cases were recruited from 6 centers in China. Procalcitonin,C-reactive protein and WBC were measured on 1st, 3rd and 5th postoperative day . Chi-square test was for the complication risk factors. One-way ANOVA was for the comparison between the biomarkers in these 4 days. ROC curves was for the complication predictive value. Results: 1) 502 with and 448 without complication, pancreatic fistula (380,40%) had the highest morbidity, while the level A B C fistula were 278,90 and 12. 2) In the non-complication subgroup, the mean baseline,POD1, POD3 and POD 5 of PCT were 0.1, 0.81, 0.93, 0.57ug/L (P=0.118); CRP were 8.39, 70.81,99.59, 49.49mg/L (P=0.000). In the complication subgroup, the mean baseline,POD1, POD3 and POD 5 of PCT were 0.09, 0.93, 0.77, 0.37(P=0.000), CRP were 9.30, 79.70, 153.01, 85.83. (P=0.000) 3) There were significant differences in the subgroups classified by occurrence of infectious complication, abdominal infection and sepsis in POD3 and POD 5 of PCT, and significant difference by occurrence of complication, pancreatic fistula in POD3 and POD 5 of CRP, WBC and neutrophil%. 5) The AUC of POD3 and POD 5 of PCT were 0.8, 0.7, 0.6 (P=0.000) to predict sepsis, abdominal infection and infectious complication. AUC of POD3 and POD5 of CRP and WBC were 0.7,0.6 (P=0.000)to predict complication and pancreatic fistula. Conclusions: PCT is better to predict infectious complication, abdominal infection and sepsis while CRP, WBC and Neutrophil % are better to predict complication and pancreatic fistula.