The predictive value of admission serum and urine carboxypeptidase-B activation peptide for the severity of acute pancreatitis: a meta-analysis

Abstract

This meta-analysis examined the predictive value of admission serum and urine carboxypeptidase-B activation peptide (CAPAP) in patients with severe acute pancreatitis. PubMed, Embase, and the Cochrane Library were searched for relevant studies published up to February 21, 2022. Seven studies (439 acute pancreatitis patients) were included. The summary sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), the area under the receiver operating characteristic curve (AUC) of admission serum CAPAP were 0.86 (95%CI: 0.76-0.93), 0.78 (95%CI: 0.68-0.85), 3.89 (95%CI: 2.56-5.91), 0.18 (95%CI: 0.09-0.33), 18.56 (95%CI: 6.99-49.30), and 0.90 (95%CI: 0.87-0.92), respectively; these values for admission urine CAPAP were 0.82 (95%CI: 0.50-0.95), 0.78 (95%CI: 0.68-0.86), 3.75 (95%CI: 2.40-5.85), 0.23 (95%CI: 0.07-0.79), 9.87 (95%CI: 3.71-26.22), and 0.84 (95%CI: 0.80-0.87), respectively. There were no significant differences between admission serum and urine CAPAP in sensitivity (1.05, 95%CI: 0.75-1.47; P = 0.781), specificity (1.00, 95%CI: 0.85-1.18; P = 1.000), PLR (1.04, 95%CI: 0.56-1.91; P = 0.906), NLR (0.78, 95%CI: 0.20-3.10; P = 0.727), and DOR (1.88, 95%CI: 0.47-7.49; P = 0.370). The AUC of serum CAPAP (1.07, 95%: 1.02-1.13; P = 0.007) was higher than that of urine CAPAP in predicting acute pancreatitis severity. Both admission serum and urine CAPAP had moderate predictive values for assessing the severity of acute pancreatitis.

Key highlights

• Both admission serum and urine carboxypeptidase-B activation peptide (CAPAP) had moderate predictive values for assessing the severity of acute pancreatitis.

• The predictive value of admission serum CAPAP was higher than that of admission urine CAPAP in predicting acute pancreatitis severity.

• Including the measurement of serum CAPAP at admission in patients with suspected pancreatitis could help triage the patients and determine the course of management.

• Hospital policymakers could consider including it among the routine tests at admission for such patients.

KEYWORDS:

• Predictive value
• serum carboxypeptidase-B activation peptide
• urine carboxypeptidase-B activation peptide
• acute pancreatitis
• meta-analysis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Liang Dai and Wei-Yan Guo provided the conceptualization of this study, drafted the manuscript, and performed data analysis. Yin-Hua Wang and Jian-Yi Pu contributed to the study’s design and collection of data. Xing-Wei Xuan, Hai-Xia Chai, and Xiao-Dong Meng worked on investigation and data collection. Jian-Li Chen and Jun-Mao Chen conducted the critical revision of the manuscript. All authors read and approved the final manuscript.

Data availability statement

The data that support the findings of this study are publicly available in the published articles which have been cited.