Early diagnosis of the Need for surgical drainage in chronic pancreatitis patients based on serum metabolomics.

Chronic pancreatitis (CP) is a chronic inflammatory disease caused by multiple factors. Numerous studies have found that implementing surgical drainage in the early stages of CP can help alleviate pain and improve prognosis in patients. However, there is currently no consensus on clinical indications for surgical drainage in the early stages of CP, making it difficult to determine whether surgical drainage is necessary. This study aims to use metabolomics methods to identify potential biomarkers that can differentiate whether CP patients require surgical drainage. This study included two cohorts. The training cohort consisted of 32 serum samples from CP patients and 31 serum samples from healthy controls. The validation cohort comprised 73 serum samples from CP patients and 27 serum samples from healthy controls. All serum samples from CP patients were collected within 24 h of hospital admission. Liquid chromatography-tandem mass spectrometry (LC-MS) was used to perform metabolomic analysis on all collected serum samples. Based on the validation cohort, 24 differential metabolites, including 1-(6-[3]-ladderane-hexanyl)-2-(8-[3]-ladderane-octanyl)-sn-glycerophosphocholine, PE(18:1(9Z)/20:4(5Z,8Z,11Z,14Z)), and PGP(16:0/20:4(5Z,8Z,11Z,14Z)), were identified as potential biomarkers for distinguishing whether CP patients require surgical drainage. Among these, the combination of 1-(6-[3]-ladderane-hexanyl)-2-(8-[3]-ladderane-octanyl)-sn-glycerophosphocholine and PE(18:1(9Z)/20:4(5Z,8Z,11Z,14Z)) demonstrated improved diagnostic value in joint ROC analysis, with an AUC value of 0.819 (95% CI: 0.691-0.924). This study represents the first prospective cohort research to identify 24 differential metabolites in serum through metabolomic profiling, which can be used for the early diagnosis of whether CP patients require surgical drainage.