Diagnostic value of procalcitonin, interleukin-6, serum amyloid A and C-reactive protein in simple and strangulated intestinal obstruction

Abstract

Objective To evaluate the value of single or combined detection of procalcitonin (PCT), interleukin-6 (IL-6), serum amyloid A (SAA) and c-reactive protein (CRP) in the differential diagnosis of simple and strangulated intestinal obstruction. Methods This retrospectively study collected 61 patients with intestinal obstruction. The patients were classified into the group of simple or strangulated intestinal obstruction according to operation. The age, sex, basic diseases, lesion sites and inflammatory indicators such as PCT, IL-6, SAA and CRP in two groups were collected and analyzed. The Students’ T-test and the Mann-Whitney U test were used to analyze normally and non-normally distributed data, respectively. The categorical variable was analyzed by the chi-square test. The receiver-operating characteristic (ROC) curve and the area under the curve (AUC) were used to predict the differential diagnostic value of single and combined detection of the above clinical inflammatory indicators. Results The serum levels of PCT, IL-6, SAA and CRP of the strangulated group were significantly higher than those of the simple group ( p < .05). The areas under the ROC curve (AUC) were 0.907 for PCT, 0.712 for IL-6, 0.723 for SAA and 0.681 for CRP. With the cutoff values of PCT (0.24 ng/L), IL-6 (19.55 pg/L), SAA (282.50 mg/L) and CRP (63.00 mg/L), the sensitivity and specificity were 86.40% and 87.20% for PCT, 68.20% and 76.90% for IL-6, 59.10% and 87.20% for SAA, 63.60% and 87.20% for CRP, respectively. And the sensitivity and specificity were 86.40% and 89.70% for combined model. The differences between PCT and the combined model are tiny and neither clinically nor statistically significant. Conclusions For discriminating strangulated intestinal obstruction from simple intestinal obstruction, PCT alone may be the preferred approach due to its simplicity.