• Raffaele Pezzilli, Massimiliano M Corsi, Alessandra Barassi, Antonio M Morselli-Labate, Alessandro D'Alessandro, Giada Dogliotti, Lorenzo Fantini, Alberto Malesci, Roberto Corinaldesi, and Gianvico Melzi d'Eril.
• Department of Internal Medicine and Gastroenterology, S Orsola Hospital, Bologna, Italy. raffaele.pezzilli@aosp.bo.it
• Pancreas. 2008 Jul 1;37(1):36-41.

ObjectivesTo evaluate the adhesion molecule time course in the early phases of acute pancreatitis and to explore the usefulness of these proteins in assessing the severity of the disease. Fifteen consecutive acute pancreatitis patients (10 patients with the mild and 5 with the severe disease) admitted to the hospital within 6 hours after the onset of pain and 15 age- and sex-matched healthy subjects.MethodsVascular cell adhesion molecule 1, intercellular adhesion molecule 1, E-selectin, P-selectin, and L-selectin were quantified on hospital admission and for the following 2 days.ResultsAcute pancreatitis patients had vascular cell adhesion molecule 1 and P-selectin concentrations significantly lower and L-selectin concentrations significantly higher than the healthy subjects. Only E-selectin was significantly higher in severe than in mild disease (P = 0.029); a value of E-selectin ranging from 3.83 to 3.92 ng/mL was the best cutoff value for differentiating severe from mild acute pancreatitis (sensitivity: 60.0%, specificity: 90.0%, cases correctly classified: 80%). E-selectin and P-selectin entered the multivariate logistic regression analysis, and a score was calculated showing a sensitivity of 93.3% and a specificity of 86.7% in identifying the patients with severe pancreatitis.ConclusionsThis score seems to be useful for the early assessment of the severity of acute pancreatitis.

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