title: Comparison of fecal elastase 1 for exocrine pancreatic insufficiency evaluation between ex-alcoholics and chronic pancreatitis patients.
abstract: BACKGROUND
  Fecal elastase is a noninvasive test for pancreatic insufficiency diagnosis.
  
  
  OBJECTIVE
  Evaluate the usefulness of fecal elastase 1 for the indication of exocrine pancreatic insufficiency among former alcohol addicts and patients with chronic pancreatitis.
  
  
  METHODS
  Forty-three patients with chronic pancreatitis and thirty-three asymptomatic former alcohol addicts entered the study. The levels of fecal elastase 1 were measured using a commercial kit. Pancreatic imaging findings were used to categorize the groups.
  
  
  RESULTS
  The levels of fecal elastase 1 were significantly lower in the patients than in the former alcohol addicts and in the group with tissue calcifications, duct alterations, or atrophy. With a cutoff level of 100 μg/g, the sensitivity of fecal elastase 1 in chronic pancreatitis was 46.51% and its specificity was 87.88% with a positive predictive value of 83.33% and a negative predictive value of 55.77%. When patients were stratified according to the severity of their pancreatitis, the sensitivity was 6.25% for mild pancreatitis and 70.37% for marked pancreatitis.
  
  
  CONCLUSIONS
  Low level of fecal elastase 1 was associated with marked rather than mild chronic pancreatitis; however, it may be useful to indicate pancreatic exocrine insufficiency in asymptomatic former alcohol addicts.
authors.affiliation: Divisão de Gastroenterologia e Hepatologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Rejane
authors.initials: R
authors.lastname: Mattar
authors.affiliation: Divisão de Gastroenterologia e Hepatologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Gustavo André Silva
authors.initials: GA
authors.lastname: Lima
authors.affiliation: Divisão de Gastroenterologia e Hepatologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Marianges Zadrozny Gouvêa
authors.initials: MZ
authors.lastname: da Costa
authors.affiliation: Divisão de Gastroenterologia e Hepatologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Joyce M Kinoshita
authors.initials: JM
authors.lastname: Silva-Etto
authors.affiliation: Divisão de Gastroenterologia e Hepatologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Dulce
authors.initials: D
authors.lastname: Guarita
authors.affiliation: Divisão de Gastroenterologia e Hepatologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Flair José
authors.initials: FJ
authors.lastname: Carrilho
mesh_terms: D000437:Alcoholism / Q000150:complications*; D015415:Biomarkers / Q000032:analysis; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis* / Q000201:enzymology; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000032:analysis*; D050500:Pancreatitis, Chronic / Q000150:complications*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D010196:Pancreatic Elastase