Citation: | LIU Qunli, ZHU Zhixiang. Diagnostic value of CT combined with serum secreted frizzled-related protein 4 and soluble suppression of tumorigenicity 2 for postoperative complicated pancreatitis in patients with malignant biliary obstruction[J]. Journal of Clinical Medicine in Practice, 2024, 28(5): 59-62, 67. DOI: 10.7619/jcmp.20232989 |
To investigate the diagnostic value of computer tomography (CT) combined with serum secreted frizzled-related protein 4 (SFRP4) and soluble suppression of tumorigenicity 2 (sST2) for pancreatitis after biliary duct stent implantation in patients with malignant biliary obstruction (MBO).
A total of 243 MBO patients with biliary duct stent implantation were selected as research objects, and they were divided into pancreatitis group with 105 cases and no pancreatitis group with 138 cases according to condition of postoperative complicated pancreatitis. Enzyme-linked immunosorbent assay was used to detect serum levels of SFRP4 and sST2, and the receiver operating characteristic (ROC) curve and the four table method were used to analyze the diagnostic values of serum SFRP4 or sST2 alone and their combination with CT for postoperative complicated pancreatitis.
The serum levels of SFRP4 and sST2 in the pancreatitis group were significantly higher than those in the no pancreatitis group (P < 0.05); the values of area under the curve (AUC) of serum SFRP4 and sST2 levels for diagnosis of postoperative complicated pancreatitis were 0.694 and 0.667, respectively. The sensitivity and specificity of CT for diagnosis of postoperative complicated pancreatitis were 76.19% and 60.87%, respectively; the sensitivity and accuracy of CT combined with serum SFRP4 and sST2 levels in diagnosing postoperative complicated pancreatitis were 98.10% and 76.54%, respectively; the sensitivity and accuracy of the combination of the three indexes for diagnosis were significantly higher than those of CT, SFRP4 or sST2 alone (P < 0.05).
MBO patients with pancreatitis after biliary duct stent implantation have higher serum levels of SFRP4 and sST2, and CT combined with serum levels of SFRP4 and sST2 has high diagnostic value for postoperative complicated pancreatitis.
[1] |
OKAMOTO T. Malignant biliary obstruction due to metastatic non-hepato-pancreato-biliary cancer[J]. World J Gastroenterol, 2022, 28(10): 985-1008. doi: 10.3748/wjg.v28.i10.985
|
[2] |
AN J L, DONG Y C, NIU H T, et al. Comparative study on nosocomial biliary tract infection rate between biliary stent loaded with radioactive 125 I seeds and conventional biliary stent in the treatment of distal malignant biliary obstruction[J]. Surg Laparosc Endosc Percutan Tech, 2022, 32(6): 724-729. doi: 10.1097/SLE.0000000000001089
|
[3] |
LEE D W, CHO C M. Predicting severity of acute pancreatitis[J]. Medicina, 2022, 58(6): 787. doi: 10.3390/medicina58060787
|
[4] |
YU P C, HE W Y, ZHANG Y Q, et al. SFRP4 is a potential biomarker for the prognosis and immunotherapy for gastric cancer[J]. J Oncol, 2022, 2022: 8829649.
|
[5] |
ROY I, JOVER E, MATILLA L, et al. Soluble ST2 as a new oxidative stress and inflammation marker in metabolic syndrome[J]. Int J Environ Res Public Health, 2023, 20(3): 2579. doi: 10.3390/ijerph20032579
|
[6] |
JIANG H, LI Q Q, HE C Z, et al. Activation of the Wnt pathway through Wnt2 promotes metastasis in pancreatic cancer[J]. Am J Cancer Res, 2014, 4(5): 537-544.
|
[7] |
TAKENAGA K, AKIMOTO M, KOSHIKAWA N, et al. Cancer cell-derived interleukin-33 decoy receptor sST2 enhances orthotopic tumor growth in a murine pancreatic cancer model[J]. PLoS One, 2020, 15(4): e0232230. doi: 10.1371/journal.pone.0232230
|
[8] |
FERNANDEZ Y VIESCA M, ARVANITAKIS M. Early diagnosis and management of malignant distal biliary obstruction: a review on current recommendations and guidelines[J]. Clin Exp Gastroenterol, 2019, 12: 415-432. doi: 10.2147/CEG.S195714
|
[9] |
WORKING GROUP IAP/APA ACUTE PANCREATITIS GUIDELINES. IAP/APA evidence-based guidelines for the management of acute pancreatitis[J]. Pancreatology, 2013, 13(Suppl 2): e1-e15.
|
[10] |
柴杰, 鲁东, 吕维富, 等. 经皮肝穿刺胆道125I粒子支架植入治疗恶性胆道梗阻疗效及安全性分析[J]. 介入放射学杂志, 2022, 31(7): 702-706. doi: 10.3969/j.issn.1008-794X.2022.07.014
|
[11] |
HE X, ZHU Y, WANG Y N, et al. Advances in stent therapy for malignant biliary obstruction[J]. Abdom Radiol, 2021, 46(1): 351-361. doi: 10.1007/s00261-020-02593-5
|
[12] |
刘文静, 李超婧, 戚晓升, 等. 抗菌型胆道支架的研究进展[J]. 中国医疗器械杂志, 2021, 45(2): 183-187, 204. doi: 10.3969/j.issn.1671-7104.2021.02.013
|
[13] |
YANG M W, TAO L Y, YANG J Y, et al. SFRP4 is a prognostic marker and correlated with Treg cell infiltration in pancreatic ductal adenocarcinoma[J]. Am J Cancer Res, 2019, 9(2): 363-377.
|
[14] |
彭俊夫, 韩永生, 黄斌. 血清SFRP4对重症急性胰腺炎患者预后的预测价值[J]. 肝胆外科杂志, 2021, 29(5): 350-353. https://www.cnki.com.cn/Article/CJFDTOTAL-GDWZ202105008.htm
|
[15] |
张进进, 唐昊, 李冉. 外周血SFRP4、S100A12水平与老年重症胰腺炎患者急性期预后的关系[J]. 老年医学与保健, 2022, 28(5): 1063-1069. https://www.cnki.com.cn/Article/CJFDTOTAL-LYBJ202205025.htm
|
[16] |
ZHANG Y, CHENG B, WU Z W, et al. Serum soluble suppression of tumorigenicity 2 as a novel inflammatory marker predicts the severity of acute pancreatitis[J]. World J Gastroenterol, 2021, 27(38): 6489-6500. doi: 10.3748/wjg.v27.i38.6489
|
[17] |
贯芳, 丁锦, 王宇彤. 血清可溶性生长刺激表达基因2蛋白在预测急性胰腺炎严重程度及预后中的临床意义[J]. 临床急诊杂志, 2022, 23(9): 626-630, 636. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZLC202209004.htm
|
[18] |
杨蕾, 王雅霄, 周长静. 重症急性胰腺炎患者早期血清可溶性致癌抑制因子2和肽素、心型脂肪酸结合蛋白的水平变化及其临床意义[J]. 广西医学, 2021, 43(4): 398-402. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYX202104003.htm
|
[19] |
CHANG K J. Identifying a biliary origin of acute pancreatitis using CT[J]. Radiology, 2022, 302(1): 127-128. doi: 10.1148/radiol.2021212066
|
[20] |
徐婷婷, 张珂珂. 多层螺旋CT检查联合血清淀粉酶、脂肪酶检测在诊断急性胰腺炎中的应用价值[J]. 当代医药论丛, 2019, 17(9): 179-180. doi: 10.3969/j.issn.2095-7629.2019.09.139
|
[21] |
董军强, 解非, 张智翔, 等. 多层螺旋CT与MRI扫描对胰腺癌和胰腺炎的鉴别诊断[J]. 实用临床医药杂志, 2023, 27(9): 8-12. doi: 10.7619/jcmp.20230321
|