Serum complex of trypsin 2 and alpha 1 antitrypsin as diagnostic and prognostic marker of acute pancreatitis: clinical study in consecutive patients.
OBJECTIVE
To estimate the usefulness of serum concentrations of the complex of trypsin 2 and alpha 1 antitrypsin in diagnosing and assessing the severity of acute pancreatitis in comparison with serum C reactive protein, amylase, and trypsinogen 2 concentrations (reference markers).


METHODS
Markers were measured in consecutive patients admitted with acute abdominal pain that was either due to pancreatitis or to other disease unrelated to the pancreas (controls).


METHODS
Department of surgery of a teaching hospital in Helsinki.


METHODS
110 patients with acute pancreatitis and 66 with acute abdominal diseases of extrapancreatic origin. On the basis of the clinical course, acute pancreatitis was classified as mild (82 patients) or severe (28 patients).


METHODS
Clinical diagnosis of acute pancreatitis and severity of the disease.


RESULTS
At admission all patients with acute pancreatitis had clearly raised concentrations of trypsin 2-alpha 1 antitrypsin complex (32 micrograms/l), whereas only three of the controls had such values. Of the markers studied, trypsin 2-alpha 1 antitrypsin complex had the largest area under the receiver operating curve, both in differentiating acute pancreatitis from extrapancreatic disease and in differentiating mild from severe disease.


CONCLUSIONS
Of the markers studied, trypsin 2-alpha 1 antitrypsin complex was the most accurate in differentiating between acute pancreatitis and extrapancreatic disease and in predicting a severe course for acute pancreatitis.
Hedström
J
J
Department of Clinical Chemistry, Helsinki University Central Hospital, Finland.
Sainio
V
V
Kemppainen
E
E
Haapiainen
R
R
Kivilaakso
E
E
Schröder
T
T
Leinonen
J
J
Stenman
U H
UH
D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000032:analysis; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis*; D011379:Prognosis; D012680:Sensitivity and Specificity; D014357:Trypsin / Q000097:blood*; D000515:alpha 1-Antitrypsin / Q000032:analysis*
D015415:Biomarkers; D000515:alpha 1-Antitrypsin; D002097:C-Reactive Protein; D000681:Amylases; D014357:Trypsin