Serum Cathodic Trypsin-like Immunoreactivity, Pancreatic Lipase, and Pancreatic Isoamylase as Diagnostic Tests of Chronic Pancreatitis or Pancreatic Steatorrhea

Abstract

We compared serum concentrations of cathodic trypsin-like immunoreactivity, pancreatic lipase, and pancreatic isoamylase as diagnostic tests of chronic pancreatitis (and of pancreatic steatorrhea in the 41 patients with steatorrhea) in 105 patients (57 men, 48 women) consecutively investigated because of clinical suspicion of chronic pancreatitis. Chronic pancreatitis (36 patients), pancreatic steatorrhea (24 patients), and other diseases were diagnosed without knowledge of the serum levels of the three enzymes. When evaluated by means of receiver operating characteristic curves, no differences were found in diagnostic performance of the enzymes with regard to chronic pancreatitis or pancreatic steatorrhea. The sensitivity and specificity for recognition of chronic pancreatitis ranged from 0.306 to 0.444 and from 0.942 to 0.986 when the discrimination values were chosen to give highest efficiencies. The similar ranges for pancreatic steatorrhea were 0.500-0.708 and 0.882-0.941. In conclusion, none of the three enzymes had any advantage over the others as diagnostic tests of chronic pancreatitis or of pancreatic steatorrhea. Only positive test results have clinical importance because of the low sensitivities of the three enzymes.

Ratios of Different Serum Pancreatic Enzymes in the Diagnosis and Staging of Chronic Pancreatitis

“…as reported by other authors [5,6,14], The limited clinical utility of serum pancreatic enzyme determinations in the diagnosis of CP is further extended in our study by the application of ratios of different enzymes. Few studies have reported a comparison among the values of different serum pan creatic enzymes in the diagnosis of CP [1,8,14], and an analysis of the ratios of these enzymes has never been pre sented. The application of ratios between enzymes does not significantly improve the accuracy of individual se rum enzymes in detecting CP.…”

Immunoreactive trypsinogen levels in pediatric patients with intestinal failure awaiting intestinal transplantation

“…Levels of IRT can be measured in blood by immunologic assays, such as RIA or ELISA. While IRT analysis is cheap, simple to perform, and risk‐free to the patients, the diagnostic value of these enzymes in a target population suspected of having chronic pancreatitis, is limited to positive test results [9]. Clinical studies on IRT have shown conflicting results.…”