Usefulness of urinary trypsinogen-2 and trypsinogen activation peptide in acute pancreatitis: A multicenter study in Japan
Year: 2019
Type: article
Study design: Observational Study
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.
Authors: Hiroaki Yasuda, Keisho Kataoka, Yoshifumi Takeyama, Kazunori Takeda, Tetsuhide Ito, Toshihiko Mayumi, Shuji Isaji, Tetsuya Mine, Motoji Kitagawa, Seiki Kiriyama, Junichi Sakagami, Atsushi Masamune, Kazuo Inui, Kenji Hirano, Ryukichi Akashi, Masamichi Yokoe, Yoshio Sogame, Kazuichi Okazaki, Chie Morioka, Yasuyuki Kihara, Shigeyuki Kawa, Masao Tanaka, Akira Andoh, Wataru Kimura, Isao Nishimori, Junji Furuse, Isao Yokota, Tooru Shimosegawa
Institutions: Kyoto Prefectural University of Medicine, Kindai University, Sendai Medical Center, National Hospital Organization, Kyushu University, University of Occupational and Environmental Health Japan, Mie University, Tokai University, Nagoya University of Arts and Sciences, Ogaki Municipal Hospital, Tohoku University, Fujita Health University Bantane Hospital, The University of Tokyo, Kumamoto Medical Center, Kumamoto Regional Medical Center, Japanese Red Cross Nagoya Daini Hospital, Kansai Medical University, Nara Medical University, Kitakyushu General Hospital, Matsumoto Dental University, Shiga University of Medical Science, Yamagata University, Kochi Medical School Hospital, Kyorin University, Hokkaido University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W2910009518