Endoscopic ultrasound and IL-8 in pancreatic juice to diagnose chronic pancreatitis.
OBJECTIVE
Pancreatic juice (PJ) [IL-8] has been proposed as a marker for pancreatic diseases. We compared the accuracy of PJ [IL-8] and endoscopic ultrasound (EUS) to diagnose chronic pancreatitis (CP).


METHODS
79 patients with symptoms suspicious for CP were enrolled. PJ emptied into the duodenum was collected during an upper endoscopy with IV secretin and [IL-8] was measured. CP was diagnosed when PJ [IL-8] was >20 pg/ml. CP was diagnosed at EUS when >or=4 of the 9 established criteria were present. CP was diagnosed by using composite gold standard: ERCP, histology, CT or MRI, and clinical follow-up (mean 20 months).


RESULTS
38 patients had CP, whereas 41 patients had no pancreatic disease. To diagnose CP, PJ [IL-8] was significantly less sensitive compared to EUS (47 vs. 71%), but equally accurate (71 vs. 80%) and specific (93 vs. 88%). By combining PJ [IL-8] and EUS, sensitivity and specificity significantly increased to 82% (either IL-8 or EUS positive) and 100% (both IL-8 and EUS positive).


CONCLUSIONS
Both PJ [IL-8] and EUS are accurate diagnostic modalities for CP. PJ collection can be performed at the time of EUS. PJ [IL-8] and EUS are complementary with higher sensitivity and specificity when used together.
Pungpapong
Surakit
S
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Jacksonville, FL 32224, USA.
Noh
Kyung W
KW
Woodward
Timothy A
TA
Wallace
Michael B
MB
Al-Haddad
Mohammad
M
Raimondo
Massimo
M
D000328:Adult; D000368:Aged; D019160:Endosonography; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010189:Pancreatic Juice / Q000737:chemistry*; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D016209:Interleukin-8