title: Faecal elastase 1: a novel, highly sensitive, and specific tubeless pancreatic function test.
abstract: BACKGROUND
  Indirect pancreatic function tests available today are unreliable for clinical practice in early chronic pancreatitis due to their low sensitivity in mild and moderate exocrine pancreatic insufficiency.
  
  
  OBJECTIVE
  To evaluate the sensitivity, specificity, and practicability of faecal elastase 1 determination in patients with mild, moderate, and severe exocrine pancreatic insufficiency categorised according to the secretin-caerulein test as "gold standard'.
  
  
  METHODS
  Faecal and duodenal elastase 1 concentration (commercial enzyme linked immunosorbent assay (ELISA)), faecal chymotrypsin activity, faecal fat analysis, and the secretin-caerulein test were performed on 44 patients with mild (n = 8), moderate (n = 14), and severe (n = 22) exocrine pancreatic insufficiency and 35 patients with gastrointestinal diseases of non-pancreatic origin. Fifty healthy volunteers were studied as normal controls. Morphological examinations were carried out to definitely confirm or exclude chronic pancreatitis.
  
  
  RESULTS
  With a cut off of 200 micrograms elastase 1/g stool the sensitivity was 63% for mild, 100% for moderate, 100% for severe, and 93% for all patients with exocrine pancreatic insufficiency, and specificity was 93%. Values for chymotrypsin were 64% (sensitivity) and 89% (specificity). Significant (p < 0.001) correlations were found for faecal and duodenal elastase with duodenal lipase, amylase, trypsin, volume, and bicarbonate output. Individual day to day variations of faecal elastase 1 concentrations were very low (mean CV = 15%) and sample storage at room temperature is possible for at least one week.
  
  
  CONCLUSIONS
  Faecal elastase 1 determination proved to be a highly sensitive and specific tubeless pancreatic function test.
authors.affiliation: Medical Department, Christian-Albrechts-University of Kiel, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Löser
authors.forename: A
authors.initials: A
authors.lastname: Möllgaard
authors.forename: U R
authors.initials: UR
authors.lastname: Fölsch
mesh_terms: D000328:Adult; D002908:Chronic Disease; D002918:Chymotrypsin / Q000032:analysis; D004386:Duodenum / Q000201:enzymology / Q000473:pathology; D005069:Evaluation Studies as Topic; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis* / Q000473:pathology; D005243:Feces / Q000737:chemistry / Q000201:enzymology*; D005260:Female; D006801:Humans; D008055:Lipids / Q000032:analysis; D008297:Male; D010196:Pancreatic Elastase / Q000032:analysis*; D012044:Regression Analysis; D012680:Sensitivity and Specificity
chemical_list: D008055:Lipids; D002918:Chymotrypsin; D010196:Pancreatic Elastase