Akut Pankreatitte Monosit Dağıtım Genişliğinin (MDW) Prognostik Değeri Var Mıdır? Bir Ön Çalışma

Abstract

Amaç: Akut pankreatit, ileri evrelerde ölümcül olabilen yaygın bir hastalıktır. Bu nedenle, akut pankreatit prognozunun erken değerlendirilmesi önemlidir. Bu çalışmanın amacı, akut pankreatit prognozunun tanımlanmasında monosit dağılım genişliğinin önemini değerlendirmektir. Gereç ve Yöntem: Çalışmaya Aralık 2019 ile Ekim 2020 arasında akut biliyer pankreatit tanısıyla hastaneye yatırılan hastalar dahil edildi. Olgular hafif pankreatit ve hafif olmayan pankreatit olarak 2 grupta değerlendirildi. Gruplar yaş, beyaz küre sayısı, nötrofil sayısı, C-reaktif protein, hastanede kalış süresi, nötrofil / lenfosit oranı, monosit dağılım genişliği, amilaz, aspartat aminotransferaz, albümin ve laktat dehidrojenaz açısından karşılaştırıldı. Results: Hafif pankreatit grubu (n: 59) ve hafif olmayan pankreatit grubu (n: 48) arasında beyaz küre sayısı, nötrofil sayısı, C-reaktif protein, Monosit Dağılımı Genişliği ve hastanede kalış süresi açısından istatistiksel olarak anlamlı fark belirlendi (p <0.05). Monosit Dağılım Genişliği için cut-off değeri 703.00 olarak alındığında, duyarlılık% 50.94 ve özgüllük% 61.11 idi. Sonuç: Monosit Dağılım Genişliği değeri, hafif pankreatiti hafif olmayan pankreatitten ayırt etmek için kullanılabilen bir parametredir. Daha net bir değerlendirme için daha kapsamlı çalışmalara ihtiyaç vardır.

Keywords

• akut pankreatit
• monosit dağılım genişliği
• prognoz

Does Monocyte Distribution Width (MDW) Have Prognostic Value in Acute Pancreatitis?

Abstract

Aim: Acute pancreatitis is a common disease that can be fatal at advanced stages. Therefore, early evaluation of the prognosis of acute pancreatitis is important. The aim of this study was to evaluate the importance of monocyte distribution width in defining the prognosis of acute pancreatitis. Materials and Methods: The study included patients hospitalized with the diagnosis of acute biliary pancreatitis between December 2019 and October 2020. The cases were evaluated in 2 groups as mild pancreatitis and non-mild pancreatitis. The groups were compared in terms of age, white blood cell, neutrophil count, C-reactive protein, length of hospital stay, neutrophil to lymphocyte ratio, Monocyte Distribution Width, amylase, Aspartate Aminotransferase, albumin, and lactate dehydrogenase. Results: A statistically significant difference was determined between the mild pancreatitis group (n:59) and non-mild pancreatitis group (n:48) in terms of white blood cell, neutrophil count, C-reactive protein, Monocyte Distribution Width and length of hospital stay (p <0.05). When the cut-off value for Monocyte Distribution Width was taken as 703.00, sensitivity was 50.94% and specificity was 61.11.8%. Conclusion: The Monocyte Distribution Width value is a parameter that can be used to differentiate mild pancreatitis from non-mild pancreatitis. More extensive studies are needed for a clearer evaluation.

Keywords

• acute pancreatitis
• monocyte distrubition width
• prognosis

References

1. Referans1 Durak, D., Senlikci, A., Dumlu, E.G. et al. Prognostic Significance of Thiol/Disulfide Ratio in the Diagnosis of Acute Biliary Pancreatitis. Indian J Surg 2020. doi.org/10.1007/s12262-020-02510-6.
2. Referans2 Goodchild G, Chouhan M, Johnson GJ. Practical guide to the management of acute pancreatitis. Frontline Gastroenterol. 2019;10(3):292-9.
3. Referans3 Sebastian Manuel Staubli, Daniel Oertli & Christian Andreas Nebiker. Laboratory markers predicting severity of acute pancreatitis, Critical Reviews in Clinical Laboratory Sciences 2015;52(6):273-83.
4. Referans4 Polilli E, Sozio F, Frattari A, et al. Comparison of Monocyte Distribution Width (MDW) and Procalcitonin for early recognition of sepsis. PLoS One. 2020;15(1):e0227300.
5. Referans5 Crouser ED, Parrillo JE, Seymour CW, et al. Monocyte Distribution Width: A Novel Indicator of Sepsis-2 and Sepsis-3 in High-Risk Emergency Department Patients. Crit Care Med. 2019;47(8):1018-25.
6. Referans6 Park HS, In SG, Yoon HJ, et al. Predictive values of neutrophil-lymphocyte ratio as an early indicator for severe acute pancreatitis in the emergency department patients. J Lab Physicians. 2019;11(3):259-64.
7. Referans7 Yarkaç A, Kose A, Bozkurt Babuş S, et al. The value of hematological parameters in acute pancreatitis. Ulus Travma Acil Cerrahi Derg. 2019;25(5):453-60.
8. Referans8 Huang L, Chen C, Yang L, et al. Neutrophil-to-lymphocyte ratio can specifically predict the severity of hypertriglyceridemia-induced acute pancreatitis compared with white blood cell. J Clin Lab Anal. 2019;33(4):e22839.

9. Referans9 Kokulu K, Günaydın YK, Akıllı NB, et al. The Relationship between the neutrophil-to-lymphocyte ratio in acute pancreatitis and the severity and systemic complications of the disease. Turk J Gastroenterol 2018; 29: 684-91.
10. Referans10 Han C, Zeng J, Lin R, et al. The utility of neutrophil to lymphocyte ratio and fluid sequestration as an early predictor of severe acute pancreatitis. Sci Rep. 2017;7(1):10704.
11. Referans11 Suppiah A, Malde D, Arab T, et al. The prognostic value of the neutrophil-lymphocyte ratio (NLR) in acute pancreatitis: identification of an optimal NLR. J Gastrointest Surg. 2013;17(4):675-81.
12. Referans12 Kaplan M, Ates I, Akpinar MY, et al. Predictive value of C-reactive protein/albumin ratio in acute pancreatitis. Hepatobiliary Pancreat Dis Int. 2017;16(4):424-30.
13. Referans13 Liang Y, Zhao X, Meng F. Procalcitonin, C-Reactive Protein, and Neutrophil Ratio Contribute to the Diagnosis and Prognosis of Severe Acute Pancreatitis. Iran J Public Health. 2019;48(12):2177-86.
14. Referans14 Staubli SM, Schäfer J, Rosenthal R, et al. The role of CRP and Pentraxin 3 in the prediction of systemic inflammatory response syndrome and death in acute pancreatitis. Sci Rep. 2019;9(1):18340.
15. Referans15 Hong W, Lin S, Zippi M, et al. Serum Albumin Is Independently Associated with Persistent Organ Failure in Acute Pancreatitis. Can J Gastroenterol Hepatol. 2017;5297143.
16. Referans16 Crouser ED, Parrillo JE, Seymour C, et al. Improved Early Detection of Sepsis in the ED With a Novel Monocyte Distribution Width Biomarker. Chest. 2017;152(3):518-26.
17. Referans17 Crouser ED, Parrillo JE, Martin GS, et al. Monocyte distribution width enhances early sepsis detection in the emergency department beyond SIRS and qSOFA. J Intensive Care. 2020;8:33.
18. Referans18 Ognibene A, Lorubbio M, Magliocca P, et al. Elevated monocyte distribution width in COVID-19 patients: The contribution of the novel sepsis indicator [published online ahead of print, 2020 Jun 3]. Clin Chim Acta. 2020;509:22-4.
19. Referans19 Agnello L, Sasso BL, Giglio RV, et al. Monocyte distribution width as a biomarker of sepsis in the intensive care unit: A pilot study. Ann Clin Biochem. 2021;58(1):70-3.