Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2019; 25(1): 107-117
Published online Jan 7, 2019. doi: 10.3748/wjg.v25.i1.107
Usefulness of urinary trypsinogen-2 and trypsinogen activation peptide in acute pancreatitis: A multicenter study in Japan
Hiroaki Yasuda, Keisho Kataoka, Yoshifumi Takeyama, Kazunori Takeda, Tetsuhide Ito, Toshihiko Mayumi, Shuji Isaji, Tetsuya Mine, Motoji Kitagawa, Seiki Kiriyama, Junichi Sakagami, Atsushi Masamune, Kazuo Inui, Kenji Hirano, Ryukichi Akashi, Masamichi Yokoe, Yoshio Sogame, Kazuichi Okazaki, Chie Morioka, Yasuyuki Kihara, Shigeyuki Kawa, Masao Tanaka, Akira Andoh, Wataru Kimura, Isao Nishimori, Junji Furuse, Isao Yokota, Tooru Shimosegawa
Hiroaki Yasuda, Keisho Kataoka, Junichi Sakagami, Yoshio Sogame, Department of Medicine, Division of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto 6028566, Japan
Keisho Kataoka, Department of Gastroenterology, Otsu Municipal Hospital, Otsu 5200804, Japan
Yoshifumi Takeyama, Department of Surgery, Kindai University Faculty of Medicine, Osakasayama 5898511, Japan
Kazunori Takeda, Department of Surgery, National Hospital Organization Sendai Medical Center, Sendai 9838520, Japan
Tetsuhide Ito, Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 8128582, Japan
Toshihiko Mayumi, Department of Emergency Medicine, University of Occupational and Environmental Health, Kitakyushu 8078555, Japan
Shuji Isaji, Department of Hepatobiliary-Pancreatic and Transplant Surgery, Mie University School of Medicine, Tsu 5148507, Japan
Tetsuya Mine, Department of Gastroenterology, Tokai University School of Medicine, Isehara 2591193, Japan
Motoji Kitagawa, Department of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin 4700196, Japan
Seiki Kiriyama, Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki 5038502, Japan
Atsushi Masamune, Tooru Shimosegawa, Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai 9808575, Japan
Kazuo Inui, Department of Gastroenterology, Fujita Health University Bantane Hospital, Nagoya 4548509, Japan
Kenji Hirano, Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo 1130033, Japan
Ryukichi Akashi, Department of Healthcare Center, Kumamoto Regional Medical Center, Kumamoto 8600811, Japan
Masamichi Yokoe, General Internal Medicine, Japanese Red Cross Nagoya Daini Hospital, Nagoya 4668650, Japan
Kazuichi Okazaki, The Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Hirakata 5731010, Japan
Chie Morioka, Third Department of Internal Medicine, Nara Medical University, Kashihara 6348521, Japan
Yasuyuki Kihara, Department of Gastroenterology, Kitakyushu General Hospital, Kitakyushu 8028517, Japan
Shigeyuki Kawa, Department of Internal Medicine, Matsumoto Dental University, Shiojiri 3990781, Japan
Masao Tanaka, Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 8128582, Japan
Akira Andoh, Division of Gastroenterology, Department of Internal Medicine, Shiga University of Medical Science, Otsu 5202192, Japan
Wataru Kimura, Department of Gastroenterological, General, Breast and Thyroid Surgery, Yamagata University Faculty of Medicine, Yamagata 9909585, Japan
Isao Nishimori, Department of Gastroenterology and Hepatology, Kochi Medical School, Nankoku 7838505, Japan
Junji Furuse, Faculty of Medicine, Department of Medical Oncology, Kyorin University, Mitaka 1818611, Japan
Isao Yokota, Department of Biostatistics, Hokkaido University, Sapporo 0600808 Japan
Author contributions: All authors helped to perform the research; Yasuda H contributed to writing the manuscript and performing procedures and data analysis; Kataoka K contributed to writing the manuscript and drafting conception and design; Takeyama Y, Takeda K, Ito T, Mayumi T, Isaji S, Mine T, Kitagawa M, Kiriyama S, Sakagami J, Masamune A, Inui K, Hirano K, Akashi R, Yokoe M, Sogame Y, Okazaki K, Morioka C, Kihara Y, Kawa S, Tanaka M, Andoh A, Kimura W, Nishimori I and Furuse J contributed to writing the manuscript; Yokota I contributed to writing the manuscript and reviewing the statistical method; Shimosegawa T contributed to writing the manuscript and drafting conception and design.
Institutional review board statement: The Institutional Review Board committee of each institution approved this study.
Informed consent statement: An informed written consent was obtained from all patients before inclusion.
Conflict-of-interest statement: The qualitative and quantitative analyses of urinary trypsinogen-2 were performed free of charge by Unitika Ltd. (Osaka, Japan). Mayumi T received research funding. The other authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hiroaki Yasuda, MD, PhD, Doctor, Senior Lecturer, Department of Medicine, Division of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, 465 Kajii-cho Kawaramachi Hirokoji Kamigyo-ku, Kyoto 6028566, Japan. hiyasuda@koto.kpu-m.ac.jp
Telephone: +81-75-2515519 Fax: +81-75-2510710
Received: October 19, 2018
Peer-review started: October 19, 2018
First decision: December 5, 2018
Revised: December 12, 2018
Accepted: December 19, 2018
Article in press: December 19, 2018
Published online: January 7, 2019
Processing time: 80 Days and 23.4 Hours
Core Tip

Core tip: A total of 94 patients with acute abdominal pain were enrolled from 17 medical institutions in Japan from April 2009 to December 2012. The trypsinogen-2 dipstick test was positive in 57 of 78 patients with acute pancreatitis (sensitivity, 73.1%) and in 6 of 16 patients with abdominal pain but without any evidence of acute pancreatitis (specificity, 62.5%). The levels of urinary trypsinogen-2 and trypsinogen activation peptide (TAP) were significantly higher in patients with extended extra-pancreatic inflammation as evaluated by CT Grade. Urinary trypsinogen-2 and TAP may be considered as additional markers to determine extra-pancreatic inflammation in acute pancreatitis.