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Hiraki M, Miyoshi A, Sadashima E, et al. The novel early predictive marker presepsin for postoperative pancreatic fistula: A pilot study. Exp Ther Med. 2020;20(3):2298-2304doi: 10.3892/etm.2020.8919.
Hiraki, M., Miyoshi, A., Sadashima, E., Shinkai, Y., Yasunami, M., Manabe, T., Kitahara, K., & Noshiro, H. (2020). The novel early predictive marker presepsin for postoperative pancreatic fistula: A pilot study. Experimental and therapeutic medicine, 20(3), 2298-2304. https://doi.org/10.3892/etm.2020.8919
Hiraki, Masatsugu, et al. "The novel early predictive marker presepsin for postoperative pancreatic fistula: A pilot study." Experimental and therapeutic medicine vol. 20,3 (2020): 2298-2304. doi: https://doi.org/10.3892/etm.2020.8919
Hiraki M, Miyoshi A, Sadashima E, Shinkai Y, Yasunami M, Manabe T, Kitahara K, Noshiro H. The novel early predictive marker presepsin for postoperative pancreatic fistula: A pilot study. Exp Ther Med. 2020 Sep;20(3):2298-2304. doi: 10.3892/etm.2020.8919. Epub 2020 Jun 19. PMID: 32765708; PMCID: PMC7401571.
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Exp Ther Med. 2020 Sep;20(3):2298-2304. doi: 10.3892/etm.2020.8919. Epub 2020 Jun 19.

The novel early predictive marker presepsin for postoperative pancreatic fistula: A pilot study.

Experimental and therapeutic medicine

Masatsugu Hiraki, Atsushi Miyoshi, Eiji Sadashima, Yukio Shinkai, Michio Yasunami, Tatsuya Manabe, Kenji Kitahara, Hirokazu Noshiro

Affiliations

  1. Department of Surgery, Saga Medical Center Koseikan, Saga 840-8571, Japan.
  2. Life Science Research Institution, Saga Medical Center Koseikan, Saga 840-8571, Japan.
  3. Clinical Laboratory, Saga Medical Center Koseikan, Saga 840-8571, Japan.
  4. Department of Surgery, Saga University Faculty of Medicine, Saga 849-8501, Japan.

PMID: 32765708 PMCID: PMC7401571 DOI: 10.3892/etm.2020.8919

Abstract

Postoperative pancreatic fistula (PF) is a major and serious complication that occurs after pancreaticoduodenectomy (PD). The aim of the current study was to evaluate the use of a novel biomarker, presepsin, for predicting clinically relevant postoperative pancreatic fistula (CR-POPF) after PD. A prospective pilot study was conducted using 30 consecutive patients who underwent PD. Risk factors and candidates for predictive biomarkers for CR-POPF were statistically analyzed. CR-POPF (grade B and C; determined according to the guidelines of the International Study Group of Pancreatic Fistula) occurred in 15 patients (50%). Univariate analysis revealed that certain underlying conditions, including non-pancreatic cancer, smaller pancreatic ducts and soft pancreas texture were significantly associated with CR-POPF (P=0.005, P=0.004 and P=0.014, respectively). Furthermore, on day 1 post surgery (POD1), white blood cell count (P=0.040), levels of serum amylase (P=0.002) and serum presepsin (P=0.012), and the concentration of presepsin in drainage fluid (P<0.001) were significantly increased in CR-POPF compared with non-CR-POPF cases. Receiver operating characteristic curve analyses revealed that, on POD1, serum amylase and the concentration of presepsin in drainage fluid had an area under the curve value exceeding 0.8. A multivariate logistic regression analysis revealed that a higher concentration of presepsin in the drainage fluid was an independent predictive marker for CR-POPF (odds ratio, 14.503; 95% confidence interval, 1.750-120.229; P=0.013). To the best of our knowledge, the present study demonstrated for the first time that presepsin concentration in drainage fluid is a useful marker of CR-POPF after PD.

Copyright © 2020, Spandidos Publications.

Keywords: pancreatic fistula; pancreaticoduodenectomy; presepsin; sCD14-ST; soluble CD14 subtype

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