Serum elastase in the diagnosis of acute pancreatitis: a prospective study.
BACKGROUND
The aim of the present study was to evaluate the usefulness of the elastase 1 (E1) enzyme-linked immunosorbent assay (ELISA) in the diagnosis of acute pancreatitis. This is the first Australian evaluation of the E1 ELISA.


METHODS
Three groups of patients were prospectively assessed: control patients, patients with acute pancreatitis, and patients with acute non-pancreatitic abdominal pain. Serum was collected on all patients on admission and the sensitivity, specificity and diagnostic accuracy of serum elastase, amylase and lipase was determined.


RESULTS
Twenty-nine patients with 30 episodes of pancreatitis, 38 patients with acute non-pancreatitic abdominal pain and 121 control patients were studied. For all patient episodes E1 ELISA at a cut-off of 3.5 ng/mL had a sensitivity of 80%, specificity of 96% and an efficiency of 94% in the diagnosis of acute pancreatitis. For episodes more than 48 h after onset of symptoms, sensitivity was 100%, specificity was 96% and diagnostic efficiency was 96%. This performance was equivalent to amylase but inferior to lipase.


CONCLUSIONS
Of the biochemical markers for pancreatitis currently available, lipase is the most useful. The relatively inferior sensitivity and problematic reference range for the ELISA E1, together with its limitations in measuring total elastase, currently prevent its widespread use.
Wilson
Robert B
RB
Department of Surgery, Bankstown-Lidcombe Hospital, Bankstown, Australia. rbwilson52@hotmail.com
Warusavitarne
Janindra
J
Crameri
Donna M
DM
Alvaro
Frank
F
Davies
David J
DJ
Merrett
Neil
N
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000097:blood*; D010195:Pancreatitis / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies
D015415:Biomarkers; D010196:Pancreatic Elastase