Objective To investigate the clinical value of combined red blood cell distribution width (RDW), mean platelet volume (MPV), mean corpuscular volume (MCV) and procalcitonin (PCT) levels in the early diagnosis of acute pancreatitis (AP).

Methods A total of 86 patients with AP were enrolled in AP group. and divided into mild acute pancreatitis (MAP) group (n=41), moderately severe acute pancreatitis (MSAP) group (n=27) and severe acute pancreatitis (SAP) group (n=18) based on the severity of their condition. An additional 80 healthy individuals undergoing routine physical examinations during the same period were recruited as control group. Peripheral blood levels of PCT, lipase (LIP), interleukin (IL)-17 and tumor necrosis factor-α (TNF-α) were measured using enzyme-linked immunosorbent assay (ELISA). RDW, MPV, MCV, triglyceride, lactate dehydrogenase and urea nitrogen levels were determined using a fully automated biochemical analyzer. Pearson correlation analysis was employed to assess the correlations between RDW, MPV, MCV, PCT levels and other indicators in AP patients. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the clinical value of peripheral blood RDW, MPV, MCV and PCT in the early diagnosis of AP.

Results The levels of body mass index, triglyceride, lactate dehydrogenase, urea nitrogen, LIP, IL-17, TNF-α, RDW, MPV, MCV and PCT in the AP group were significantly higher than those in the control group (P < 0.05). The RDW, MPV, MCV and PCT levels were significantly higher in the MSAP and SAP groups than in the MAP group, and the RDW, MPV, MCV and PCT levels in the SAP group were significantly higher than those in the MSAP group (P < 0.05). Pearson correlation analysis revealed positive correlations between RDW, MPV, MCV as well as PCT levels and body mass index, triglyceride, lactate dehydrogenase, urea nitrogen, LIP, IL-17 as well as TNF-α levels in the AP patients (P < 0.05). ROC curve analysis indicated that the areas under the curve (AUCs) for early diagnosis of AP using peripheral blood RDW, MPV, MCV and PCT were 0.780, 0.873, 0.818 and 0.830, respectively. The AUC for combined diagnosis using these four markers was 0.972, with a specificity of 92.50% and a sensitivity of 93.02%. The combined diagnosis of RDW, MPV, MCV and PCT demonstrated superior diagnostic value compared to individual markers (Z=5.060, 3.250, 4.162, 4.272, P < 0.05).

Conclusion The RDW, MPV, MCV and PCT levels were elevated in the AP patients, and their combined diagnosis of early AP was of high clinical value.