Clinical value of rapid urine trypsinogen-2 test strip, urinary trypsinogen activation peptide, and serum and urinary activation peptide of carboxypeptidase B in acute pancreatitis.
OBJECTIVE
To assess the usefulness of urinary trypsinogen-2 test strip, urinary trypsinogen activation peptide (TAP), and serum and urine concentrations of the activation peptide of carboxypeptidase B (CAPAP) in the diagnosis of acute pancreatitis.


METHODS
Patients with acute abdominal pain and hospitalized within 24 h after the onset of symptoms were prospectively studied. Urinary trypsinogen-2 was considered positive when a clear blue line was observed (detection limit 50 microg/L). Urinary TAP was measured using a quantitative solid-phase ELISA, and serum and urinary CAPAP by a radioimmunoassay method.


RESULTS
Acute abdominal pain was due to acute pancreatitis in 50 patients and turned out to be extrapancreatic in origin in 22 patients. Patients with acute pancreatitis showed significantly higher median levels of serum and urinary CAPAP levels, as well as amylase and lipase than extrapancreatic controls. Median TAP levels were similar in both groups. The urinary trypsinogen-2 test strip was positive in 68% of patients with acute pancreatitis and 13.6% in extrapancreatic controls (P<0.01). Urinary CAPAP was the most reliable test for the diagnosis of acute pancreatitis (sensitivity 66.7%, specificity 95.5%, positive and negative predictive values 96.6% and 56.7%, respectively), with a 14.6 positive likelihood ratio for a cut-off value of 2.32 nmol/L.


CONCLUSIONS
In patients with acute abdominal pain, hospitalized within 24 h of symptom onset, CAPAP in serum and urine was a reliable diagnostic marker of acute pancreatitis. Urinary trypsinogen-2 test strip showed a clinical value similar to amylase and lipase. Urinary TAP was not a useful screening test for the diagnosis of acute pancreatitis.
Sáez
Jesús
J
Department of Internal Medicine, Hospital General Universitario de Alicante, Pintor Baeza s/n, E-03010 Alicante, Spain.
Martínez
Juan
J
Trigo
Celia
C
Sánchez-Payá
José
J
Compañy
Luis
L
Laveda
Raquel
R
Griñó
Pilar
P
García
Cristina
C
Pérez-Mateo
Miguel
M
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000652:urine; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000652:urine; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D010455:Peptides / Q000097:blood / Q000652:urine; D011237:Predictive Value of Tests; D014357:Trypsin / Q000652:urine; D014362:Trypsinogen / Q000652:urine
D015415:Biomarkers; D009842:Oligopeptides; D010455:Peptides; C110925:carboxypeptidase B activation peptide; C080396:trypsinogen activation peptide; C064831:PRSS2 protein, human; D014362:Trypsinogen; D014357:Trypsin