Mean Platelet Volume as a New Inflammatory Marker in Acute Pancreatitis and Its Relation to C-Reactive Protein and Ranson’s Score on Admission

Öz

Aim: The study’s aim is to evaluate mean platelet volume (MPV) as a marker of inflammation in patients with acute pancreatitis (AP) and to analyse the relationships among MPV, CRP (C-reactive protein) and Ranson’s score. Material and Methods: In this study, 119 patients with AP (mean age 53.8 ± 18.0 years) and 88 healthy control group (mean age 53.1 ± 6.8 years) were enrolled. Among the patients with AP, 75 were classified as having biliary AP, and 44 were classified as having nonbiliary AP. All patients’ demographic data, clinical and laboratory findings and Ranson’s scores were examined from the hospital’s database. Results: MPV was significantly lower among patients with AP than among the control group (p = 0.001). CRP was significantly higher among patients with AP than among the control group (p< 0.001). The difference in MPV between the biliary and nonbiliary AP group was statistically not significant. When we compared MPV based on patients’ lengths of hospital stay, there was no significant difference. In correlation analysis, there was no correlation among CRP, Ranson’s score and serum MPV levels. Conclusion: We observed that MPV levels in the AP group were lower than healthy controls. Thus, like other inflammation markers, MPV might be a useful marker for AP diagnosis.

Anahtar Kelimeler

• Acute pancreatitis
• Mean platelet volume
• Inflammation

Akut Pankreatitte Yeni Bir İnflamatuar Belirteç Olarak Ortalama Trombosit Hacmi ve C-Reaktif Protein ile Başvuru Anındaki Ranson Skoru ile İlişkisi

Öz

Amaç: Bu çalışmada akut pankreatitli (AP) hastalarda inflamasyon belirteci olarak ortalama trombosit hacmini (MPV) değerlendirmek ve MPV, CRP (C-reactive protein) ile Ranson skoru arasındaki ilişkiyi inceleme amaçlandı. Gereç ve Yöntemler: Bu çalışmaya AP’li 119 hasta (ortalama yaş 53.8 ± 18.0 yıl) ve 88 sağlıklı kontrol grubu (ortalama yaş 53.1 ± 6.8 yıl) alındı. AP’li hastalardan 75’i biliyer AP, 44’ü biliyer olmayan AP olarak sınıflandırıldı. Tüm hastaların demografik verileri, klinik ve laboratuvar bulguları ve Ranson skorları hastanenin veri tabanından incelendi. Bulgular: MPV, AP’li hastalarda kontrol grubuna göre anlamlı olarak daha düşüktü (p = 0.001). AP’li hastalarda CRP, kontrol grubuna göre anlamlı olarak daha yüksekti (p < 0.001). Biliyer ve biliyer olmayan AP grup arasındaki MPV farkı istatistiksel olarak anlamlı bulunmadı. Hastaların hastanede kalış sürelerine göre MPV değerlerini karşılaştırdığımızda anlamlı bir fark yoktu. Korelasyon analizinde CRP, Ranson skoru ve serum MPV seviyeleri arasında korelasyon yoktu. Sonuç: AP grubunda MPV düzeylerinin sağlıklı kontrollere göre daha düşük olduğunu gözlemledik. Bu nedenle, diğer inflamasyon belirteçleri gibi MPV de AP tanısı için yararlı bir belirteç olabilir

Anahtar Kelimeler

• Akut pankreatit
• Ortalama trombosit hacmi
• inflamasyon

Kaynakça

1. 1. Sarles H, Adler G, Dani R, Frey C, Gullo L, Harada H, Martin E, Norohna M, Scuro LA. Classifications of pancreatitis and definition of pancreatic diseases. Digestion 1989;43(4):234- 236.
2. 2. Sarles H. Revised classification of pancreatitis--Marseille 1984. Dig Dis Sci 1985;30(6):573-574.
3. 3. Matull WR, Pereira SP, O’Donohue JW. Biochemical markers of acute pancreatitis. J Clin Pathol 2006;59(4):340-344.
4. 4. Yadav D, Lowenfels AB. The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology 2013;144(6):1252-1261.
5. 5. Fagenholz PJ, Castillo CF, Harris NS, Pelletier AJ, Camargo CA Jr. Increasing United States hospital admissions for acute pancreatitis, 1988-2003. Ann Epidemiol 2007;17(7):491-497.
6. 6. Leal C, Almeida N. Predicting severity in acute pancreatitis: A never-ending quest. GE port J Gastroenterol 2019;26(4):232- 234.
7. 7. Zhou H, Mei X, He X, Lan T, Guo S. Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase: A retrospective study. Medicine (Baltimore) 2019;98(16):e15275.
8. 8. Leader A, Pereg D, Lishner M. Are platelet volume indices of clinical use? A multidisciplinary review. Ann Med 2012;44(8):805-816.

9. 9. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, Tsiotos GG, Vege SS; Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis--2012: Revision of the Atlanta classification and definitions by international consensus. Gut 2013;62(1):102- 111.
10. 10. Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): New perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm 2019;9213074.
11. 11. Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Localio SA. Objective early identification of severe acute pancreatitis. Am J Gastroenterol 1974;61(6):443-451.
12. 12. De Bernardinis M, Violi V, Roncoroni L, Boselli AS, Giunta A, Peracchia A. Discriminant power and information content of Ranson’s prognostic signs in acute pancreatitis: A metaanalytic study. Crit Care Med 1999;27:2272-2283.
13. 13. Peery AF, Dellon ES, Lund J, Crockett SD, McGowan CE, Bulsiewicz WJ, Gangarosa LM, Thiny MT, Stizenberg K, Morgan DR, Ringel Y, Kim HP, DiBonaventura MD, Carroll CF, Allen JK, Cook SF, Sandler RS, Kappelman MD, Shaheen NJ. Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology 2012;143(5):1179-1187.e3.
14. 14. Fagenholz PJ, Ferna C, Harris NS, Pelletier AJ, Camargo Jr CA. Direct medical costs of acute pancreatitis hospitalizations in the United States. Pancreas 2007;35(4):302-307.
15. 15. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: A link between thrombosis and inflammation? Curr Pharm Des 2011;17(1):47-58.
16. 16. Kisacik B, Tufan A, Kalyoncu U, Karadag O, Akdogan A, Ozturk MA, Kiraz S, Ertenli I, Calguneri M. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008;75(3):291-294.
17. 17. Beyazit Y, Sayilir A, Torun S, Suvak B, Yesil Y, Purnak T, Oztas E, Kurt M, Kekilli M, Ibis M. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol 2012;36(2):162-168.
18. 18. Erbis H, Aliosmanoglu I, Turkoglu MA, Ay E, Turkoglu A, Ulger BV. Evaluating mean platelet volume as a new indicator for confirming the diagnosis of necrotizing pancreatitis. Ann Ital Chir 2015;86:132-136.
19. 19. Papadopoulos VP, Filippou DK, Mimidis KP. Mean platelet volume in acute pancreatitis: A systematic review and metaanalysis. Ann Gastroenterol 2020;33(4):398-404.
20. 20. Lei JJ, Zhou L, Liu Q, Xiong C, Xu CF. Can mean platelet volume play a role in evaluating the severity of acute pancreatitis? World J Gastroenterol 2017;23(13):2404-2413.
21. 21. Ranson J. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 1974; 139:69-81.
22. 22. Mimidis K, Papadopoulos V, Kotsianidis J, Filippou D, Spanoudakis E, Bourikas G, Dervenis C, Kartalis G. Alterations of platelet function, number and indexes during acute pancreatitis. Pancreatology 2004;4(1):22-27.
23. 23. agyu T, Saito H, Sakamoto T, Uchinaka E, Morimoto M, Hanaki T, Watanabe J, Matsunaga T, Yamamoto M, Tokuyasu N, Honjo S, Fujiwara Y. Decreased mean platelet volume predicts poor prognosis in patients with pancreatic cancer. BMC Surg 2021 6;21(1):8.
24. 24. Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol 2018;9:754.
25. 25. Zareifar S, Farahmand Far MR, Golfeshan F, Cohan N. Changes in platelet count and mean platelet volume during infectious and inflammatory disease and their correlation with ESR and CRP. J Clin Lab Anal 2014;28(3):245-248.
26. 26. Kapsoritakis AN, Koukourakis MI, Sfiridaki A, Potamianos SP, Kosmadaki MG, Koutroubakis IE, Kouroumalis EA. Mean platelet volume: A useful marker of inflammatory bowel disease activity. Am J Gastroenterol 2001;96(3):776-781