IDDF2024-ABS-0062 The early predictive value of neutrophil to lymphocyte ratio for the severity of acute biliary pancreatitis and pancreatic necrosis

<h3>Background</h3> The neutrophil-to-lymphocyte ratio (NLR) has been proposed as an inexpensive and widely available marker in many diseases. In this study, we aimed to assess the value of NLR in predicting the severity and pancreatic necrosis (PN) in acute biliary pancreatitis (ABP). <h3>Methods</h3> 290 patients with ABP were enrolled in this study. Blood samples were collected within 24 hours after acute pancreatitis (AP) onset. The optimal cut-off value for NLR to predict severe AP (SAP) and PN was determined by receiver operating characteristic (ROC) curve analysis. The ABP model was induced by taurocholic acid sodium in rats. The blood and pancreatic tissue samples were collected, and we compared NLR at different time points and concentrations of taurocholic acid sodium. <h3>Results</h3> The area under the ROC curve showed NLR had a predictive performance for SAP (AUC: 0.823, SE: 0.056, 95% CI: 0.713- 0.934, p=0.000). The optimal cut-off from the ROC curve was 13.38 (sensitivity: 80.0%; specificity: 83.2%). For the prediction of PN, the AUC of NLR was 0.910 (SE: 0.025, 95% CI: 0.861-0.958, p=0.000). The cut-off value of NLR was 9.265 (sensitivity: 97.1%; specificity: 72.7%). In taurocholic acid sodium-induced ABP in rats, the NLR increased significantly and peaked earlier than PN (IDDF2024-ABS-0062 Figure 1. Continuous changes in NLR and pancreatic necrosis area). The NLR was observed to increase along with the increase in the extent of PN (IDDF2024-ABS-0062 Figure 2. Comparison of NLR and pancreatic necrosis area). <h3>Conclusions</h3> In summary, neutrophil to lymphocyte ratio (NLR) at the initial stage (within 24h after the onset) may serve as an early and powerful marker for predicting severity and PN in ABP.