Comprehensive statistical analysis of serum interleukin-6 and C-reactive protein for early diagnosis of severe acute pancreatitis: A systematic review and meta-analysis.

Background: Severe acute pancreatitis (SAP) is a life-threatening condition requiring early diagnosis for timely intervention. Interleukin-6 (IL-6) is a pro-inflammatory cytokine that rises earlier in response to inflammation. C-reactive protein (CRP) is commonly used but has limited early diagnostic accuracy. This meta-analysis aims to head-to-head compare the diagnostic accuracy of IL-6 and CRP for early SAP diagnosis.

Methods: We systematically searched PubMed, Cochrane Library, and Google Scholar databases for relevant studies published until June 2024. We included those observational studies that reported the sensitivity and specificity of IL-6 and CRP for early SAP diagnosis. We compared the predictive accuracy of IL-6 versus CRP using pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristics area under the curve (SROC AUC). Heterogeneity was assessed using I statistic. Subgroup and meta-regression analyses were performed to address significant heterogeneity. Deeks' funnel plot was used to evaluate publication bias.

Results: Meta-analysis included 17 studies with 1517 patients diagnosed with AP, of which 496 had SAP. The pooled sensitivity, specificity, DOR, and SROC AUC of IL-6 were 86%, 81%, 25, and 0.90, respectively, while for CRP, they were 75%, 75%, 9, and 0.81, respectively. The comparative predictive accuracy of IL-6 versus CRP showed a significant difference in pooled sensitivity ( = 0.041) and SROC AUC ( < 0.001) but comparable specificity ( = 0.286) and DOR ( = 0.102).

Conclusion: IL-6 shows greater diagnostic accuracy than CRP for early SAP diagnosis. IL-6 can be considered both an early diagnostic and follow-up biomarker for AP.