Evaluation of Pankrin, a new serum test for diagnosis of acute pancreatitis.
OBJECTIVE
Evaluation of a new serum test for diagnosis of acute pancreatitis.


METHODS
One hundred and sixty-three patients presenting with acute abdominal pain were included into the study. Acute pancreatitis was diagnosed by CT or ultrasound. Serum samples were taken 0-1 days, 2-3 days, and 4-5 days after onset of symptoms and C-reactive protein, lipase, elastase, and amylase were determined. As a further parameter, Pankrin, a newly available kit for the measurement of a mixture of elastase and other pancreatic secretory proteins was used. As control, serum from 558 apparently healthy blood donors was analysed. The receiver operator characteristics (ROC) and the areas under the curves (AUC) were calculated for each individual test.


RESULTS
In Western blot analysis the antibodies of the Pankrin assay detected the majority of protein bands in human pancreatic juice. In blood donors, the median value of Pankrin was 88 U/ml (range 14-316 U/ml). In 16 from 163 patients with acute abdominal pain, acute pancreatitis was diagnosed and the median Pankrin level in samples collected on days 0-1 was 345 U/ml (range 220-518 U/ml, p<0.0001). In those patients with abdominal pain but without pancreatitis, the median was 116 U/ml (range 17-396 U/ml). The ROC-curves for amylase, lipase, elastase, and Pankrin from samples collected after 0-1 days were similar (area under the curves (AUC) >0.98). After 2-3 days, the AUC of all markers decreased (AUC 0.80-0.89) and after 4-5 days the AUC of Pankrin (0.85) was higher than all other parameters.


CONCLUSIONS
In those patients with abdominal pain, who present several days after onset of pain, the new serum test for pancreatitis, Pankrin, could be of help to improve the diagnosis of pancreatitis.
Keim
Volker
V
Medizinische Klinik und Poliklinik II, Universitätsklinikum Leipzig, Philipp Rosenthal Strasse 27, D-04103, Leipzig, Germany. keimv@medizin.uni-leipzig.de
Teich
Niels
N
Bodeker
Hans
H
Mossner
Joachim
J
D000006:Abdomen, Acute / Q000097:blood; D015746:Abdominal Pain / Q000097:blood*; D000681:Amylases / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005069:Evaluation Studies as Topic; D006801:Humans; D008049:Lipase / Q000097:blood; D010196:Pancreatic Elastase / Q000097:blood; D010189:Pancreatic Juice / Q000737:chemistry / Q000201:enzymology; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012372:ROC Curve; D011933:Reagent Kits, Diagnostic; D012016:Reference Values; D012680:Sensitivity and Specificity; D014362:Trypsinogen / Q000097:blood
D011933:Reagent Kits, Diagnostic; D014362:Trypsinogen; D002097:C-Reactive Protein; D008049:Lipase; D000681:Amylases; D010196:Pancreatic Elastase