Clinical Value of Serum Soluble B7-H4 in Evaluating the Condition and Disease Outcome of Patients with Acute Pancreatitis

ZHANG Li; ZHANG Yang; GUO Hong

doi:10.3969/j.issn.1004-437X.2025.01.003

Abstract：Objective To explore the clinical value of serum soluble B7 homolog 4(sB7-H4)in evaluating the condition and disease outcome of patients with acute pancreatitis(AP).Methods A total of 82 AP patients admitted to the First Affiliated Hospital of Henan University of Science and Technology from February 2020 to September 2022 were selected as the research objects.According to the severity of the disease,they were divided into severe group(SAP group),moderate group(MSAP group),and mild group(MAP group).According to the outcome,they were divided into improvement group(31 cases),protracted group(38 cases),and death group(13 cases).The level of serum sB7-H4 was detected by double antibody sandwich enzyme-linked immunosorbent assay.The receiver operating characteristic(ROC)curve was used to assess the predictive value of serum sB7-H4 for the severity of AP and the outcome of the disease.The prognostic factors of AP patients were explored by multivariate logistic regression analysis.Results Serum procalcitonin(PCT),C-reactive protein(CRP),tumor necrosis factor α(TNF-α),and acute physiology and chronic health evaluation Ⅱ(APACHE-Ⅱ)scores in SAP group were higher than those in MSAP and MAP groups,and PCT,CRP,TNF-α,APACHE-Ⅱ score in MSAP group was higher than that of the MAP group(P＜0.05).The serum sB7-H4 level of SAP group was higher than that of MSAP group and MAP group,and the serum sB7-H4 level of MSAP group was higher than that of MAP group(P＜0.05).The serum sB7-H4 level and APACHE-Ⅱ score in the improvement group were lower than those in the prolonged group and the death group,and the serum sB7-H4 level and APACHE-Ⅱ score in the prolonged group were lower than those in the death group(P＜0.05).The APACHE-Ⅱ scores of patients in SAP group,MSAP group and MAP group were positively correlated with serum sB7-H4(r=0.514,0.469,0.524,P＜0.05).Serum sB7-H4 levels were positively correlated with PCT,CRP and TNF-α(r=0.464,0.634,0.514,P＜0.05).The area under the curve of serum sB7-H4 for diagnosis of severe illness and death in AP patients was 0.817(0.754-0.880)and 0.897(0.815-0.979).Severity,CRP,APACHE-Ⅱ score,high expression of serum sB7-H4 were risk factors for death in AP patients(P＜0.05).Conclusion Serum soluble B7-H4 level in AP patients is related to the severity of the disease and the outcome of the disease.The high expression of serum sB7-H4 is a risk factor for the prognosis of patients with acute pancreatitis,and it can be used as a biomarker for clinical diagnosis and treatment of AP,providing a reference for early diagnosis,clinical treatment and prognosis evaluation.