Urinary trypsinogen-2 for diagnosing acute pancreatitis: a meta-analysis.
BACKGROUND
Currently, serum amylase and lipase are the most popular laboratory markers for early diagnosis of acute pancreatitis with reasonable sensitivity and specificity. Urinary trypsinogen-2 (UT-2) has been increasingly used but its clinical value for the diagnosis of acute pancreatitis and post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis has not yet been systematically assessed.


METHODS
A comprehensive search was carried out using PubMed (MEDLINE), Embase, and Web of Science for clinical trials, which studied the usefulness of UT-2 as a diagnostic marker for acute pancreatitis. Sensitivity, specificity and the diagnostic odds ratios (DORs) with 95% confidence interval (CI) were calculated for each study and were compared with serum amylase and lipase. Summary receiver-operating curves were conducted and the area under the curve (AUC) was evaluated.


RESULTS
A total of 18 studies were included. The pooled sensitivity and specificity of UT-2 for the diagnosis of acute pancreatitis were 80% and 92%, respectively (AUC=0.96, DOR=65.63, 95% CI: 31.65-139.09). The diagnostic value of UT-2 was comparable to serum amylase but was weaker than serum lipase. The pooled sensitivity and specificity for the diagnosis of post-ERCP pancreatitis were 86% and 94%, respectively (AUC=0.92, DOR=77.68, 95% CI: 24.99-241.48).


CONCLUSIONS
UT-2 as a rapid test could be potentially used for the diagnosis of post-ERCP pancreatitis and to an extent, acute pancreatitis. Further studies are warranted to confirm these results.
Sichuan Provincial Pancreatitis Center, Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu 610041, China. xiaqing@medmail.com.cn
Tao
T
Jin
Wei
W
Huang
Kun
K
Jiang
Jun-Jie
JJ
Xiong
Ping
P
Xue
Muhammad A
MA
Javed
Xiao-Nan
XN
Yang
Qing
Q
Xia
D000681:Amylases / Q000097:blood; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D006801:Humans; D008049:Lipase / Q000097:blood; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology / Q000652:urine; D012680:Sensitivity and Specificity; D014357:Trypsin / Q000652:urine*; D014362:Trypsinogen / Q000652:urine*
D015415:Biomarkers; C064831:PRSS2 protein, human; D014362:Trypsinogen; D008049:Lipase; D000681:Amylases; D014357:Trypsin