Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb;14(2):667-674.
doi: 10.4103/jfmpc.jfmpc_1366_24. Epub 2025 Feb 21.

Diagnostic accuracy of interleukin-6 as a biomarker for early prediction of severe acute pancreatitis: A systematic review and meta-analysis

Shishir Kumar  1 , Tarique Aziz  1 , Rajendra Kumar  2 , Pramod Kumar  3 , Amit Kumar  4 , Avijit Saha  1 , Divakar Kumar  5 , Mukesh Kumar Niraj  1
Affiliations

Diagnostic accuracy of interleukin-6 as a biomarker for early prediction of severe acute pancreatitis: A systematic review and meta-analysis

Shishir Kumar et al. J Family Med Prim Care. 2025 Feb.

Abstract

Background: Acute pancreatitis (AP) is an inflammatory disease of the pancreas with varying severity. The mortality rate varies from 20% to 40% among severe acute pancreatitis (SAP). Interleukin-6 (IL-6) is a pro- and anti-inflammatory cytokine that involves various infections, inflammations, and systemic disorders. Injury to acinar cells leads to necrosis, releasing proinflammatory cytokines, including IL-6, which peaks earlier. The lack of extensive data regarding the association of IL-6 with AP influences us to do this meta-analysis for early detection and treatment of AP to prevent multiorgan failure.

Methods: We searched the PubMed, Cochrane Library, and Google Scholar databases for relevant articles published from inception to June 2024. We examined the positive and negative likelihood ratios, diagnostic odds ratios, and pooled sensitivity and specificity. We used the QUADAS-2 tool to evaluate the risk of bias.

Results: This meta-analysis included 13 studies involving 1386 patients with AP, of which 343 had SAP and 1043 had mild and moderately severe AP. The positive and negative likelihood ratios were 3.5 (95% CI 2.6 to 4.5) and 0.25 (95% CI 0.16 to 0.40). The diagnostic odds ratio of IL-6 to diagnose SAP is 14 (95% CI: 7 to 27), and the summary receiver operating characteristic curve is 0.85 (95% CI: 0.82-0.88).

Conclusion: Based on the results of this meta-analysis, serum IL-6 is a promising biomarker for diagnosing SAP in the early stage. However, a larger-scale study involving a more extensive population is necessary due to the considerable variation between the studies.

Keywords: Acute pancreatitis; IL-6; diagnostic accuracy; sensitivity; specificity.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Study flow diagram (PRISMA) representing the study selection and inclusion
Figure 2
Figure 2
Summary risk of bias for each domain
Figure 3
Figure 3
Risk of bias for individual studies. Risk of bias and applicability concerns summary: review authors’ judgements about each domain for each included study
Figure 4
Figure 4
Forest plot of pooled sensitivity and specificity for diagnosing SAP
Figure 5
Figure 5
Summary ROC curve with confidence and prediction contours showing discriminatory power of IL-6 in the diagnosis of SAP. The X-axis represents the specificity of IL-6 for its discriminating accuracy in diagnosing SAP. The Y-axis represents the sensitivity of IL-6 for its discriminating accuracy in diagnosing SAP. ROC, receiver operating characteristic
Figure 6
Figure 6
Fagan nomogram shows IL-6’s pretest and post-test probability in diagnosing SAP, IL-6, Interleukin-6; SAP - Sever Acute Pancreatitis
Figure 7
Figure 7
Deek’s funnel plot for assessment of risk of publication bias
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Schepers NJ, Bakker OJ, Besselink MG, Ahmed Ali U, Bollen TL, Gooszen HG, et al. Impact of characteristics of organ failure and infected necrosis on mortality in necrotizing pancreatitis. Gut. 2019;68:1044–51. - PubMed
    1. Agarwal S, George J, Padhan RK, Vadiraja PK, Behera S, Hasan A, et al. Reduction in mortality in severe acute pancreatitis: A time trend analysis over 16 years. Pancreatology. 2016;16:194–9. - PubMed
    1. Roberts SE, Akbari A, Thorne K, Atkinson M, Evans PA. The incidence of acute pancreatitis: Impact of social deprivation, alcohol consumption, seasonal and demographic factors. Aliment Pharmacol Ther. 2013;38:539–48. - PMC - PubMed
    1. Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139:69–81. - PubMed
    1. Blamey SL, Imrie CW, O'Neill J, Gilmour WH, Carter DC. Prognostic factors in acute pancreatitis. Gut. 1984;25:1340–6. - PMC - PubMed

LinkOut - more resources