Correlations between serum trypsinogen-2 and pancreatic cancer.
OBJECTIVE
To investigate associations be- tween serum trypsinogen-2, pancreatitis and pancreatic cancer (PC) and determine cutoff values for PC diagnosis.


METHODS
We recruited 88 patients from Internal Medicine/Surgical Departments of General Military Hospital of Beijing PLA between 12/2009 and 6/2010. Serum samples were collected preoperatively from 23 PC patients, 30 pancreatitis patients and 35 healthy controls. Enzyme-linked immunosorbent assay was used to detect trypsinogen-2 semiquantitatively.


RESULTS
Serum trypsinogen-2 levels of PC and pancreatitis patients were significantly higher than those of controls (51.2 ± 80.3, 107.7 ± 98.1 vs. 1.0 ± 0.5, p = 0.03, p < 0.001) and significantly higher in pancreatitis vs. PC patients (107.7 ± 98.1 vs. 51.2 ± 80.3, p = 0.01). Higher Balthazar CT grades correlated with higher trypsinogen-2 in pancreatitis group. ROC curves for trypsinogen-2 revealed optimal cutoff value 1.8 as lower PC detection limit with 95.7% sensitivity and 91.4% specificity, and optimal cutoff value 19.9 for upper PC detection limit with 87.0% sensitivity and 97.1% specificity. Trypsinogen-2 levels correlated with pancreatic injury level. An AUC of 0.73 (95% Cl: 0.59-0.84, p = 0.002) distinguished PC from pancreatitis.


CONCLUSIONS
Serum trypsinogen-2 is associated with PC and pancreatitis. Levels between 1.8 μg/L and 19.9 μg/L strongly suggest PC. Detection of serum trypsinogen-2 may provide simple, sensitive, specific non-invasive initial screening for early PC diagnosis.
Jianbiao
J
Cao
Changhong
C
Xia
Tingting
T
Cui
Hanbin
H
Guo
Haoran
H
Li
Yongqiang
Y
Ren
Shuai
S
Wang
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood; D016022:Case-Control Studies; D002681:China; D055088:Early Detection of Cancer; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006772:Hospitals, Military; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000201:enzymology* / Q000601:surgery; D010195:Pancreatitis / Q000097:blood* / Q000201:enzymology* / Q000601:surgery; D011237:Predictive Value of Tests; D012372:ROC Curve; D012720:Severity of Illness Index; D014357:Trypsin / Q000097:blood*; D014362:Trypsinogen / Q000097:blood*; D015854:Up-Regulation
D014408:Biomarkers, Tumor; C064831:PRSS2 protein, human; D014362:Trypsinogen; D014357:Trypsin