Value of soluble fms-like tyrosine kinase 1 for predicting acute pancreatitis severity: a systematic review and meta-analysis

Wang, Sheng-Nan; Tang, Tao; Zhou, Wei-Mei

doi:10.1590/1806-9282.20231694

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Revista da Associação Médica Brasileira

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Original Article • Rev. Assoc. Med. Bras. 70 (5) • 2024 • https://doi.org/10.1590/1806-9282.20231694 copy

Value of soluble fms-like tyrosine kinase 1 for predicting acute pancreatitis severity: a systematic review and meta-analysis

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

The objective of this study was to explore the relationship between serum soluble fms-like tyrosine kinase 1 and the severity of acute pancreatitis and its diagnostic utility.

METHODS:

This study was carried out by searching Chinese and English literature from the establishment of the database to July 9, 2023, systematically, and assessing the quality and heterogeneity of the articles included.

RESULTS:

Thirteen studies with a total of 986 patients were included. Patients with severe acute pancreatitis showed higher levels of soluble fms-like tyrosine kinase 1 compared with mild acute pancreatitis [weighted mean difference=76.64 pg/mL, 95% confidence interval (95%CI 50.39–102.89, p<0.001)]. Soluble fms-like tyrosine kinase 1 predicted pooled sensitivity, specificity, and area under the curve were 79%, 74%, and 0.85 for severe acute pancreatitis, with some heterogeneity (I²>50% or p<0.05). In the subgroup analysis, cutoff >150 pg/mL was found to be a heterogeneous factor.

CONCLUSION:

Soluble fms-like tyrosine kinase 1 is a reliable tool for identifying acute pancreatitis severity, but only as a screening tool.

KEYWORDS:
Vascular endothelial growth factor receptor-1; Acute pancreatitis; Systematic review; Meta-analysis

		Category	Parameter	No. of studies	Sensitivity (95%)	P1	Specificity (95%)	P2	p-value	I²
SAP	Definition of severity	Yes	Atlanta classification	3	0.85 [0.74–0.96]	0.51	0.68 [0.57–0.79]	0.00	0.04	70
	Definition of severity	No	Others	4	0.77 [0.69–0.85]	0.51	0.81 [0.75–0.88]	0.00	0.04	70
	Study design	Yes	Prospective	2	0.88 [0.77–0.99]	0.93	0.70 [0.57–0.82]	0.00	0.07	62
	Study design	NO	Retrospective	5	0.76 [0.68–0.83]	0.93	0.79 [0.73–0.86]	0.00	0.07	62
	Geographical location	Yes	Asia	4	0.77 [0.69–0.85]	0.02	0.81 [0.75–0.88]	0.41	0.04	70
	Geographical location	No	Others	3	0.85 [0.74–0.96]	0.02	0.68 [0.57–0.79]	0.41	0.04	70
	sFlt-1 sampling time	Yes	≤24 h	2	0.82 [0.75–0.89]	0.55	0.77 [0.70–0.85]	0.13	0.17	44
	sFlt-1 sampling time	NO	>24 h	2	0.69 [0.57–0.81]	0.55	0.75 [0.63–0.87]	0.13	0.17	44
	Sample size	Yes	>100	2	0.72 [0.63–0.82]	0.00	0.79 [0.68–0.90]	0.15	0.10	57
	Sample size	NO	≤ 100	5	0.84 [0.77–0.91]	0.00	0.75 [0.67–0.84]	0.15	0.10	57
	Cutoff value	Yes	>150 pg/mL	3	0.81 [0.70–0.92]	0.39	0.83 [0.76–0.90]	0.21	0.00	84
	Cutoff value	NO	≤150 pg/mL	3	0.78 [0.65–0.91]	0.39	0.71 [0.64–0.78]	0.21	0.00	84
	Methods	Yes	ELISA	5	0.76 [0.68–0.83]	0.02	0.79 [0.73–0.86]	0.37	0.07	62
	Methods	NO	ECLIA	2	0.88 [0.77–0.99]	0.02	0.70 [0.57–0.82]	0.37	0.07	62
AP	Definition of severity	Yes	Atlanta classification	1	0.81 [0.60–1.00]	0.99	0.62 [0.53–0.71]	0.00	0.04	68
	Definition of severity	No	Others	4	0.76 [0.64–0.88]	0.99	0.79 [0.72–0.85]	0.00	0.04	68
	Study design	Yes	Prospective	2	0.84 [0.73–0.95]	0.97	0.77 [0.64–0.89]	0.31	0.28	22
	Study design	NO	Retrospective	3	0.72 [0.58–0.86]	0.97	0.72 [0.62–0.82]	0.31	0.28	22
	sFlt-1 sampling time	Yes	≤24 h	3	0.81 [0.70–0.92]	0.89	0.71 [0.61–0.81]	0.03	0.55	0
	sFlt-1 sampling time	NO	>24 h	2	0.71 [0.54–0.89]	0.89	0.78 [0.67–0.88]	0.03	0.55	0
	Sample size	Yes	>100	1	0.51 [0.42–0.61]	0.00	0.79 [0.65–0.92]	0.48	0.00	82
	Sample size	NO	≤100	4	0.82 [0.78–0.87]	0.00	0.73 [0.63–0.82]	0.48	0.00	82
	Cutoff value	Yes	>150 pg/mL	3	0.83 [0.74–0.92]	0.86	0.68 [0.59–0.77]	0.00	0.05	66
	Cutoff value	NO	≤150 pg/mL	2	0.66 [0.51–0.82]	0.86	0.81 [0.72–0.90]	0.00	0.05	66

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[1] *Corresponding author: weimeizhou04@126.com