Importance of cytokeratine 18 in the patients with acute pancreatitis, and corelation of clinical progress of acute pancreatitis and cytokeratine 18 level which is a marker of apoptosis

In some studies, it?s shown that apoptosis of pancreatic aciner cells is important in the pathogenesis and prognosis of acute pancreatitis. In last years, there are a few animal experiments about it. In these experiments importance of cytokeratine 18 (CK18) is found relatied with pancreatic aciner cell apoptosis. In this study we aimed to search the corelation of CK18 level and clinical progress of acute pancreatitis. And also we searhed if CK18 level might be a positive marker in the clinical progress of acute pancreatitis, which is not shown before.58 patients with a diagnosis of acute pancreatitis who were followed up in Gaziantep Univercity Medical Faculty Hospital Gastroenerology Department were enrolled to the study. Patients are divided into 2 groups clinically due to Ranson criteria as mild or severe acute pancreatitis. Patient with Ranson score higher or equal to 6, were classified as severe, and Ranson score lower than 6 were classified as might acute pancreatitis. In the first day of hospitalisation, we got blood sample from all patients to evaluate CK18 level. Blood samples were seperated to serums and we kept all serums in -80°C. 4 patients were excluded from the study due to the hemolytic and lipophilic serum samples.36 patients (%66,7) were classified as mild pancreatitis and 18 patients (%33,7) were classifed as severe acute pancreatitis group. In comparison of CK18 levels of the two groups, CK18 level of the patients in mild acute pancretitis group was statistically significantly higher than in severe acute pancreatitis group (p<0,001).In conclusion, we found a correlation between CK 18 levels and clinical presentation of acute pancreatitis. In mild pancreatitis group, which the apopitotic cascade was dominant, the serum CK18 levels were higher as a marker of apopitosis and in severe pancreatitis the serum CK18 levels were lower. So, it is thought that serum CK18 levels might be a marker for acute pancreatitis clinical presentation.Key words: Cytokeratine 18, Severe acute pancreatitis, Mild acute pancreatitis