Accuracy of angiopoietin-2 for predicting organ failure in patients with acute pancreatitis: a systematic review and meta-analysis

Abstract

Objective Our aim was to assess the accuracy of angiopoietin-2 (Ang-2) as a prognostic marker for acute pancreatitis (AP) with organ failure (OF). Methods We undertook a systematic search of the PubMed, Cochrane Library, Embase, Chinese Journals Full-text, Wanfang, China Biology Medicine disc, and Weipu databases to identify eligible cohort studies on the predictive value of Ang-2 for AP with OF. The main outcome measures were sensitivity and specificity. The effects were pooled using a bivariate mixed-effects model. Results Six articles with seven case-control studies (n = 650) were included. Pooled sensitivity, specificity, and positive and negative likelihood ratios with 95% confidence intervals (CI) for AP with OF were 0.93 (95%CI: 0.75–0.99), 0.85 (95%CI: 0.75–0.92), 6.40 (95%CI: 3.36–12.19), and 0.08 (95%CI: 0.02–0.36), respectively. The area under the summary receiver operating characteristic curve was 0.95 (95%CI: 0.92–0.96), and the diagnostic odds ratio was 83.18 (95%CI: 11.50–623.17). Subgroup analysis showed that admission time of AP onset (< or ≥24 hours) was a source of overall heterogeneity. Sensitivity analysis supported this finding. Conclusion Ang-2 had high diagnostic accuracy for AP with OF; the best prediction of Ang-2 may be 24 to 72 hours after onset of AP.

Adipokines and their role in acute pancreatitis

“…Further subgroup and sensitivity analyses indicated that Ang-2's most effective predictive ability is observed between 24 and 72 hours after the onset of AP. These findings suggest that Ang-2 has the poten-tial to serve as a valuable predictor of AP severity in future clinical applications (24).…”

Progress in the Study of Laboratory Indicators Related to Acute Pancreatitis

“…Lv Yongcai et al [16] showed that on day 1, Ang-2 predicted POF value better than traditional predictors, with a sensitivity of 83.30%, a specificity of 68.40%, and an AUC of 0.738 when its cut-off value was 126.44 μg/L, whereas Ang-2 predicted PN value as the best single biochemical indicator when the cut-off value of Ang-2 was 130.9 μg/L, it had a sensitivity of 77.3%, a specificity of 73.6%, and an AUC of 0.703. According to a systematic evaluation and meta-analysis by Lv et al [17] the results of a systematic evaluation and meta-analysis showed that Ang-2 had high diagnostic accuracy for AP combined with OF; the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of combined OF were 0.93, 0.85, 6.40, and 0.08, respectively. the AUC = 0.95, and the optimal prediction time of Ang-2 might be 24 -72 h after the onset of AP.…”

Modern Aspects of Pathogenesis and Diagnosis of Acute Pancreatitis

“…Ангіопоетин-2 -глікопротеїн, що вибірково діє на ендотеліальні клітини та бере участь в ангіогенезі, диференціації клітин та регуляції проникності судинної стінки. Нині існує багато досліджень, присвячених вивченню вмісту ангіопоетину-2 як можливого предиктора розвитку ПОН та тяжкого перебігу ГП (значення, що перевищує 11,76 нг/мл у перші 24 год з моменту появи болю), чутливість тесту становить 100%, специфічність -95,2% [67].…”