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Usefulness of urinary trypsinogen-2 and trypsinogen activation peptide in acute pancreatitis:A multicenter study in Japan

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World Journal of Gastroenterology 2019年第1期25卷 107-117页

作者： 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 Department of Medicine Division of Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Department of Surgery Kindai University Faculty of Medicine Department of Surgery National Hospital Organization Sendai Medical Center Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Department of Emergency Medicine University of Occupational and Environmental Health Department of Hepatobiliary-Pancreatic and Transplant Surgery Mie University School of Medicine Department of Gastroenterology Tokai University School of Medicine Department of Nutritional Sciences Nagoya University of Arts and Sciences Department of Gastroenterology Ogaki Municipal Hospital Division of Gastroenterology Tohoku University Graduate School of Medicine Department of Gastroenterology Fujita Health University Bantane Hospital Department of Gastroenterology Graduate School of Medicine University of Tokyo Department of Healthcare Center Kumamoto Regional Medical Center General Internal Medicine Japanese Red Cross Nagoya Daini Hospital The Third Department of Internal Medicine Division of Gastroenterology and Hepatology Kansai Medical University Third Department of Internal Medicine Nara Medical University Department of Gastroenterology Kitakyushu General Hospital Department of Internal Medicine Matsumoto Dental University Department of Surgery and Oncology Graduate School of Medical SciencesKyushu University Division of Gastroenterology Department of Internal Medicine Shiga University of Medical Science Department of Gastroenterological General Breast and Thyroid SurgeryYamagata University Faculty of Medicine Department of Gastroenterology and Hepatology Kochi Medical School Faculty of Medicine Department of Medical Oncology Kyorin University Department of Biostatistics Hokkaido University

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 *** To reconfirm the validity of all these markers in the diagnosis of acute pancreatitis by undertaking a multi-center study in *** 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 *** 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 *** 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.

关键词： Acute pancreatitis trypsinogen activation peptide Urinary trypsinogen-2 dipstick test

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Early prediction of severe acute pancreatitis by urinary trypsinogen activation peptide

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Hepatobiliary & Pancreatic Diseases International 2002年第2期1卷 285-289页

作者： Liu Z.-S. Jiang C.-Q. Qian Q. Sun Q. Fan L.-F. Ai Z.-L. Department of General Surgery Zhongnan Hospital Wuhan University Wuhan 430071 China

Objective: To investigate the value of urinary trypsi-nogen activation peptide (TAP) in the early predic-tion of severe acute pancreatitis and to compare itwith acute physiology and chronic health evaluationⅡ (APACHE Ⅱ).Methods: We assessed the predictive value of urinaryTAP concentrations measured by a competitive en-zyme-linked immunosorbent assay. Urine sampleswere collected for detecting TAP concentrations atadmission, and 24, 48, and 72 h from 41 patientswith acute pancreatitis (12 with severe disease, 29with mild disease) who presented within 48 h the on-set of symptoms and from 11 control patients, whileAPACHE Ⅱ scores were recorded at 48 h after ***: The peak median urinary TAP concentrationwas seen at admission. The median urinary TAPconcentration at admission for severe pancreatitis (95nmol/L) was significantly higher than the medianfor patients with mild pancreatitis (20 nmol/L, P<0. 005) and controls (15 nmol/L, P<0. 005). TAPconcentrations were significantly higher in patientswith severe acute pancreatitis than the median in pa-tients with mild pancreatitis (P<0. 05) and controls(P<0. 05) on days 2 to 3. The median APACHE Ⅱscores of severe patients were significantly differentfrom those of mild patients (10.5 vs 6.0, P<0.01).The sensitivity, specificity, positive predictive, andnegative predictive values of an admission urinaryTAP≥35 nmol/L for severe pancreatitis were91.7%, 89.7%, 78.6% and 96.3%, whereas 48 hafter admission the values for APACHE Ⅱ scores(≥9) were 75.0%, 72.7%, 52.9% and 87.5%. Inprediction of disease severity, the urine TAP concen-tration was much better than APACHE Ⅱ at 48 ***: Urinary TAP obtained at the first 48 hof the onset of symptoms can predict severe acutepancreatitis. In prediction of disease severity, theurinary TAP is much better than APACHE Ⅱ score.

关键词： acute pancreatitis trypsinogen activation peptide APACHE Ⅱ

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Hereditary pancreatitis

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World Journal of Gastroenterology 2003年第1期9卷 1-4页

作者： Richard M Charnley Consultant Surgeon Freeman HospitalNewcastle upon TyneNE7 7DNUK

Hereditary pancreatitis is an autosomal dominant condition,which results in recurrent attacks of acute pancreatitis,progressing to chronic pancreatitis often at a young *** majority of patients with hereditary pancreatitis expressone of two mutations (R122H or N29I) in the cationictrypsinogen gene (PRSS1 gene). It has been hypothesisedthat one of these mutations, the R122H mutation causespancreatitis by altering a trypsin recognition site sopreventing deactivation of trypsin within the pancreas andprolonging its action, resulting in autodigestion. Families withthese two mutations have been identified in many countriesand there are also other rarer mutations, which have alsobeen linked to hereditary *** with hereditary pancreatitis present in the sameway as those with sporadic pancreatitis but at an earlierage. It is common for patients to remain undiagnosed formany years, particularly ifthey present with non-specificsymptoms. Hereditary pancreatitis should always beconsidered in patients who present with recurrent pancreatitiswith a family history of pancreatic disease. If patients withthe 2 common mutations are compared, those with theR122H mutation are more likely to present at a younger ageand are more likely to require surgical intervention than thosewith N29I. Hereditary pancreatitis carries a 40 % lifetimerisk of pancreatic cancer with those patients aged between50 to 70 being most at risk in whom screening tests maybecome important.

关键词： Trypsin Genetic Counseling Genetic Screening Humans Pancreatitis Point Mutation Risk Factors trypsinogen

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新发现的胰蛋白酶原基因多位点突变病例(英文)

新发现的胰蛋白酶原基因多位点突变病例(英文)

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中华医学会第七次全国检验医学学术会议

作者：刘奇才郜峰程祖建欧启水福建医科大学附属第一医院

BACKGROUD There has been reports that some individuals with chronic pancreatitis have alterations in the trysinogen gene (PRSS1).The conversion of trypsinogen to trypsin while still in the pancreas is believed to be one of the causes for *** i- dentify the mutation of protease serine 1(PRSS1)gene in a Chinese patient with chronic pancreatitis and analyse it’s clinical feature.

关键词： trypsinogen multisite mutation chronic pancreatitis

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