1. Usefulness of urinary trypsinogen-2 and trypsinogen activation peptide in acute pancreatitis: A multicenter study in Japan
- Author
-
Keisho Kataoka, Kazuo Inui, Toshihiko Mayumi, Akira Andoh, Masao Tanaka, Junichi Sakagami, Motoji Kitagawa, Wataru Kimura, Isao Yokota, Shuji Isaji, Hiroaki Yasuda, Tooru Shimosegawa, Yoshio Sogame, Tetsuhide Ito, Atsushi Masamune, Masamichi Yokoe, Kazunori Takeda, Kenji Hirano, Kazuichi Okazaki, Yoshifumi Takeyama, Junji Furuse, Seiki Kiriyama, Isao Nishimori, Ryukichi Akashi, Yasuyuki Kihara, Chie Morioka, Shigeyuki Kawa, and Tetsuya Mine
- Subjects
Adult ,Male ,medicine.medical_specialty ,Trypsinogen ,Urinary system ,Gastroenterology ,digestive system ,Severity of Illness Index ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Japan ,Retrospective Study ,Internal medicine ,medicine ,Humans ,Trypsin ,Prospective Studies ,Aged ,Retrospective Studies ,Urinary trypsinogen-2 dipstick test ,Aged, 80 and over ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,digestive system diseases ,Acute pancreatitis ,chemistry ,Multicenter study ,Pancreatitis ,030220 oncology & carcinogenesis ,Area Under Curve ,Trypsinogen activation peptide ,030211 gastroenterology & hepatology ,Female ,business ,Oligopeptides ,Biomarkers - Abstract
BACKGROUND Rapid urinary trypsinogen-2 dipstick test and levels of urinary trypsinogen-2 and trypsinogen activation peptide (TAP) concentration have been reported as prognostic markers for the diagnosis of acute pancreatitis. AIM To reconfirm the validity of all these markers in the diagnosis of acute pancreatitis by undertaking a multi-center study in Japan. METHODS Patients with acute abdominal pain were recruited from 17 medical institutions in Japan from April 2009 to December 2012. Urinary and serum samples were collected twice, at enrollment and on the following day for measuring target markers. The diagnosis and severity assessment of acute pancreatitis were assessed based on prognostic factors and computed tomography (CT) Grade of the Japanese Ministry of Health, Labour, and Welfare criteria. RESULTS A total of 94 patients were enrolled during the study period. The trypsinogen-2 dipstick test was positive in 57 of 78 patients with acute pancreatitis (sensitivity, 73.1%) and in 6 of 16 patients with abdominal pain but without any evidence of acute pancreatitis (specificity, 62.5%). The area under the curve (AUC) score of urinary trypsinogen-2 according to prognostic factors was 0.704, which was highest in all parameter. The AUC scores of urinary trypsinogen-2 and TAP according to CT Grade were 0.701 and 0.692, respectively, which shows higher than other pancreatic enzymes. The levels of urinary trypsinogen-2 and TAP were significantly higher in patients with extended extra-pancreatic inflammation as evaluated by CT Grade. CONCLUSION We reconfirmed urinary trypsinogen-2 dipstick test is useful as a marker for the diagnosis of acute pancreatitis. Urinary trypsinogen-2 and TAP may be considered as useful markers to determine extra-pancreatic inflammation in acute pancreatitis.
- Published
- 2019