Basic Research
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2005; 11(46): 7261-7265
Published online Dec 14, 2005. doi: 10.3748/wjg.v11.i46.7261
Clinical value of rapid urine trypsinogen-2 test strip, urinary trypsinogen activation peptide, and serum and urinary activation peptide of carboxypeptidase B in acute pancreatitis
Jesús Sáez, Juan Martínez, Celia Trigo, José Sánchez-Payá, Luis Compañy, Raquel Laveda, Pilar Griñó, Cristina García, Miguel Pérez-Mateo
Jesús Sáez, Juan Martínez, Luis Compañy, Pilar Griñó, Raquel Laveda, Cristina García, Miguel Pérez-Mateo, Section of Gastroenterology and Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain
Celia Trigo, Service of Clinical Laboratory, Hospital General Universitario de Alicante, Alicante, Spain
José Sánchez-Payá, Service of Preventive Medicine, Hospital General Universitario de Alicante, Alicante, Spain
Author contributions: All authors contributed equally to the work.
Supported by grants from the Instituto de Salud Carlos III No. C03/02, No. G03/156
Correspondence to: Dr Miguel Pérez-Mateo, Department of Internal Medicine, Hospital General Universitario de Alicante, Pintor Baeza s/n, E-03010 Alicante, Spain. perzmato_mig@gva.es
Telephone: +34-96-5938345 Fax: +34-96-5938355
Received: February 24, 2005
Revised: July 2, 2005
Accepted: July 8, 2005
Published online: December 14, 2005
Abstract

AIM: To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP), and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnosis of acute pancreatitis.

METHODS: Patients with acute abdominal pain and hospitalized within 24 h after the onset of symptoms were prospectively studied. Urinary trypsinogen-2 was considered positive when a clear blue line was observed (detection limit 50 μg/L). Urinary TAP was measured using a quantitative solid-phase ELISA, and serum and urinary CAPAP by a radioimmunoassay method.

RESULTS: Acute abdominal pain was due to acute pancreatitis in 50 patients and turned out to be extrapancreatic in origin in 22 patients. Patients with acute pancreatitis showed significantly higher median levels of serum and urinary CAPAP levels, as well as amylase and lipase than extrapancreatic controls. Median TAP levels were similar in both groups. The urinary trypsinogen-2 test strip was positive in 68% of patients with acute pancreatitis and 13.6% in extrapancreatic controls (P<0.01). Urinary CAPAP was the most reliable test for the diagnosis of acute pancreatitis (sensitivity 66.7%, specificity 95.5%, positive and negative predictive values 96.6% and 56.7%, respectively), with a 14.6 positive likelihood ratio for a cut-off value of 2.32 nmol/L.

CONCLUSION: In patients with acute abdominal pain, hospitalized within 24 h of symptom onset, CAPAP in serum and urine was a reliable diagnostic marker of acute pancreatitis. Urinary trypsinogen-2 test strip showed a clinical value similar to amylase and lipase. Urinary TAP was not a useful screening test for the diagnosis of acute pancreatitis.

Keywords: Acute pancreatitis; Urinary trypsinogen-2; Urinary trypsinogen activation peptide; Activation peptide of carboxypeptidase B; Acute abdominal pain