Clinical Trials Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2017; 23(14): 2592-2600
Published online Apr 14, 2017. doi: 10.3748/wjg.v23.i14.2592
Endothelial progenitor cells in peripheral blood may serve as a biological marker to predict severe acute pancreatitis
Xiao-Qin Ha, Yue-Juan Song, Hong-Bin Zhao, Wei-Wei Ta, Hong-Wei Gao, Qiang-Sheng Feng, Ju-Zi Dong, Zhi-Yun Deng, Hong-Yan Fan, Jun-Hua Peng, Zhi-Hua Yang, Yong Zhao
Xiao-Qin Ha, Yue-Juan Song, Hong-Bin Zhao, Wei-Wei Ta, Hong-Wei Gao, Qiang-Sheng Feng, Ju-Zi Dong, Zhi-Yun Deng, Hong-Yan Fan, Jun-Hua Peng, Zhi-Hua Yang, Yong Zhao, Department of Clinical Laboratory, Lanzhou Military Command General Hospital of the People’s Liberation Army, Key Laboratory of Stem Cell and Gene Medicine of Gansu Province, 730050 Lanzhou, Gansu Province, China
Wei-Wei Ta, The Second Clinical Medical College, Lanzhou University, 730000 Lanzhou, Gansu Province, China
Author contributions: Ha XQ and Song YJ designed the study and wrote the manuscript; Peng JH, Yang ZH and Zhao Y performed the majority of experiments; Feng QS and Fan HY provided vital reagents and analytical tools and were also involved in editing the manuscript; Zhao HB, Ta WW, Gao HW and Dong JZ coordinated and provided the collection of all the human material in addition to providing financial support for this work; all the authors contributed to this manuscript.
Supported by the National Natural Science Foundation of China, No. 30772577 and No. 81060015; and the Gansu Province Science Foundation for Young Scholars, No. 145RJYA320.
Institutional review board statement: The study was reviewed and approved by the Department of Clinical Laboratory of the Lanzhou Military Command General Hospital of the People’s Liberation Army and Key Lab of Stem Cells and Gene Drugs of Gansu Province.
Clinical trial registration statement: This registration policy applies to prospective, randomized, controlled trials only.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xiao-Qin Ha, Professor, Department of Clinical Laboratory, Lanzhou Military Command General Hospital of the People’s Liberation Army, Key Laboratory of Stem Cell and Gene Medicine of Gansu Province, 730050 Lanzhou, Gansu Province, China. haxq@yahoo.com
Telephone: +86-931-8994525 Fax: +86-931-2653965
Received: November 16, 2016
Peer-review started: November 17, 2016
First decision: December 19, 2016
Revised: January 3, 2017
Accepted: January 18, 2017
Article in press: January 18, 2017
Published online: April 14, 2017
Processing time: 148 Days and 19.2 Hours
Abstract
AIM

To investigate the significance of endothelial progenitor cells (EPCs) in predicting severe acute pancreatitis (SAP).

METHODS

We recruited 71 patients with acute pancreatitis (AP) and excluded 11 of them; finally, cases of mild acute pancreatitis (MAP) (n = 30) and SAP (n = 30), and healthy volunteers (n = 20) were internalized to investigate levels of EPCs, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), fibrinogen (FIB) and white blood cells (WBC) in peripheral blood.

RESULTS

The levels of TNF-α, WBC, FIB and CRP were higher both in SAP and MAP cases than in healthy volunteers (P < 0.05, all). Interestingly, the level of EPCs was higher in SAP than MAP (1.63% ± 1.47% vs 6.61% ± 4.28%, P < 0.01), but there was no significant difference between the MAP cases and healthy volunteers (1.63% ± 1.47% vs 0.55% ± 0.54%, P > 0.05). Receiver operating characteristics curve (ROC) showed that EPCs, TNF-α, CRP and FIB were significantly associated with SAP, especially EPCs and CRP were optimal predictive markers of SAP. When the cut-off point for EPCs and CRP were 2.26% and 5.94 mg/dL, the sensitivities were 90.0% and 73.3%, and the specificities were 83.3% and 96.7%. Although, CRP had the highest specificity, and EPCs had the highest sensitivity and highest area under the curve value (0.93).

CONCLUSION

Data suggest that EPCs may be a new biological marker in predicting SAP.

Keywords: Severe acute pancreatitis; Marker; Endothelial progenitor cells

Core tip: Endothelial progenitor cells (EPCs) may be used as a novel biological marker to predict the severity of acute pancreatitis (AP) considering the relation between endothelial cells and EPCs. We compared five markers, and concluded that EPCs had the highest area under the curve value (0.93) and Youden index (0.8), sensitivity (90.0%) and specificity (83.3%). EPCs may represent a new biological marker for predicting severe AP at the early stage.